CAJ | 학술논문

目的探讨2型糖尿病合并结直肠癌患者的临床病理特征.方法分析经病理确诊的3 202例结直肠癌患者的临床资料,比较结直肠癌患者中2型糖尿病(376例)与非糖尿病患者(2 826例)的临床病理特征.结果 2005-2009年天津市人民医院结直肠癌患者人数逐年增加,呈现老龄化趋势,高发年龄为51～ 80岁,男女比例为1.18∶1,以溃疡型、中分化腺癌为主.2型糖尿病与非糖尿病患者均以直肠癌患者最为常见,分别为242例(64.4％)和1 942例(68.7％);其次为乙状结肠癌,分别为47例(12.5％)和368例(13.0％).2型糖尿病患者的年龄为(66.2±9.3)岁,高于非糖尿病患者[(62.7±12.1)岁,P＜0.001].2型糖尿病患者同时性多原发结直肠癌(2处或2处以上部位)患者所占比例为3.5％,高于非糖尿病患者(1.6％,P＜0.001),而且2型糖尿病患者Dukes分期C期和D期患者所占比例为52.6％,高于非糖尿病患者(45.6％,P＜0.05).2型糖尿病和非糖尿病合并结直肠癌患者的性别、大体分型、组织学分型和分化程度差异均无统计学意义(均P ＞0.05).结论结直肠癌发病率逐年增加,呈现老龄化趋势,其中2型糖尿病合并结直肠癌患者发病年龄、淋巴结及远处器官的转移率明显高于非糖尿病患者.
목적 탐토2형당뇨병합병결직장암환자적림상병리특정.방법 분석경병리학진적3 202례결직장암환자적림상자료,비교결직장암환자중2형당뇨병(376례)여비당뇨병환자(2 826례)적림상병리특정.결과 2005-2009년천진시인민의원결직장암환자인수축년증가,정현노령화추세,고발년령위51～ 80세,남녀비례위1.18∶1,이궤양형、중분화선암위주.2형당뇨병여비당뇨병환자균이직장암환자최위상견,분별위242례(64.4％)화1 942례(68.7％);기차위을상결장암,분별위47례(12.5％)화368례(13.0％).2형당뇨병환자적년령위(66.2±9.3)세,고우비당뇨병환자[(62.7±12.1)세,P＜0.001].2형당뇨병환자동시성다원발결직장암(2처혹2처이상부위)환자소점비례위3.5％,고우비당뇨병환자(1.6％,P＜0.001),이차2형당뇨병환자Dukes분기C기화D기환자소점비례위52.6％,고우비당뇨병환자(45.6％,P＜0.05).2형당뇨병화비당뇨병합병결직장암환자적성별、대체분형、조직학분형화분화정도차이균무통계학의의(균P ＞0.05).결론 결직장암발병솔축년증가,정현노령화추세,기중2형당뇨병합병결직장암환자발병년령、림파결급원처기관적전이솔명현고우비당뇨병환자.
Objective the aim of this study was to determine the clinicopathological characteristics of colorectal cancer(CRC)patients complicated with type 2 diabetes mellitus (T2DM).Methods A total of 3,202 patients with CRC confirmed pathologically in Tianjin Union Medicine Center from January 2005 to December 2009 were included in this study.We analyzed the differences in clinicopathological features between T2DM patients and non-diabetic patients according to age of diagnosis,gender,tumor site,stage,gross type,histological type,and differentiation.Results From 2005 to 2009,the number of CRC patients increased yearly.The high incidence age of all CRC patients was 51 to 80 years old.The male to female ratio was 1.18∶1,showing that the number of female patients with CRC was increased significantly compared with males.The CRC distribution of T2DM patients and non-diabetic patients showed a predominance of rectal cancer (64.4％,68.7％),followed by sigmoid colon cancer (12.5％,13.0％),and moderately differentiated ulcer-type adenocarcinoma.Compared with non-diabetic patients,T2DM patients were older (66.2 years versus 62.7 years,P ＜0.001) and had more multiple CRCs (3.5％ versus 1.6％,P ＜0.001).Moreover,the proportion of lymph node or organ metastasis in T2DM patients was higher than that in non-diabetic patients (52.6％ versus 45.6％,P ＜ 0.05).No significant differences were observed between both groups in terms of gender,gross type,histological type,and differentiation(P ＞ 0.05 for all).Conclusions CRC incidence shows an increasing trend with age.CRC patients with T2DM have an older age of onset,higher proportion of lymph node and distant organ metastasis than in non-diabetic patients.