2型糖尿病对结直肠癌患者临床病理特征和预后的影响.docVIP

2型糖尿病对结直肠癌患者临床病理特征和预后的影响 　　[摘要] 目的 探讨2型糖尿病对结直肠癌患者临床病理特征和转移、预后的影响。方法 收集708例结直肠癌患者临床资料和病理标本，按照静脉血糖水平分为2型糖尿病组（A组）和血糖正常组（B组），分别观察两组标本病理分化程度、浸润深度、TNM分期、淋巴结转移、远处转移和脉管癌栓；随访两组患者的生存时间。结果 A组为195人（27.5%），B组为513人（72.5%）；A组浸润深度、TNM分期、淋巴结转移、远处转移和脉管癌栓与B组相比均有明显，差异有统计学意义（P0.05）；A组平均生存时间和5年生存率显著低于B组，差异有统计学意义 （P0.05）。 结论 2型糖尿病对结直肠癌侵袭和转移具有协同作用，降低患者的生存时间和生存率。 　　[关键词] 结直肠癌；2型糖尿病；病理；预后 　　[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-0742（2014）06（b）-0028-02 　　[Abstract] Objective To investigate the clinicopathological characteristics and prognosis of colorectal cancer patients complicated with type 2 diabetes mellitus. Methods The clinical data and pathological specimens of 708 cases of patients with colorectal cancer were collected， and they were divided into type 2 diabetes mellitus group （group A） and normal blood glucose group （group B） according to venous blood glucose level. The pathological differentiation， depth of invasion， TNM stage， lymph node metastasis， distant metastasis and cancer embolus of two groups of specimens were observed respectively. The survival time of two groups of patients was followed up. Results The number of group A and group B was 195（27.5%） and 513（72.5%）， respectively. Compared the depth of invasion， TNM stage， lymph node metastasis， distant metastasis and cancer embolus of group A with those of group B， the differences between the groups were statistically significant（P0.05）； the mean survival time and survival rate of 5 years of group A was significantly shorter than that of group B（P0.05）. Conclusion Type 2 diabetes mellitus has a synergistic effect on the invasion and metastasis of colorectal cancer， which can reduce the survival time and survival rate of the patients. 　　[Key words] Colorectal cancer； Type 2 diabetes mellitus； Pathology； Prognosis 　　近二十年来，随着饮食结构和生活方式等因素的改变，我国结直肠癌的发病率迅速增加，已成为增长最快的肿瘤之一[1]。我国2型糖尿病患者的人数也逐年增多，两种疾病拥有相似的高危因素：摄入高脂肪、高热量食物过多；摄入高纤维食物过少；运动缺乏等[2]。国外研究显示，胰岛素水平升高可能是结直肠癌发生发展的危险因素之一[3]。国内对2型糖尿病和结直肠癌之间的发病关系研究较少。为探讨2型糖尿病对结直肠癌患者临床病理特征和转移