CAJ | 학술논문

目的探讨胰腺癌合并糖尿病患者放疗后血糖变化情况及其相关因素.方法回顾性分析了69例Ⅰ～Ⅲ期胰腺癌合并糖尿病患者的临床资料,根据糖尿病病程分组,分析各组的临床特征及经过立体定向放疗以后各组患者血糖变化的情况,并分析血糖与肿瘤标志物变化的相关性.结果糖尿病程＜12个月的胰腺癌患者占39.1％,远高于其他病程的患者.经有效治疗后,糖尿病病程＜12个月与病程12 ～24个月患者的血糖改善情况比较,差异无统计学意义(P=0.519);而与病程25 ～36个月和病程＞36个月的患者比较,血糖的改善率差异均有统计学意义(均P＜0.05).经有效治疗后,糖尿病病程＜12个月、病程12～24个月的患者随着CA199或癌胚抗原(CEA)水平的降低,血糖亦有相应的改善,两者呈正相关(r分别为0.834和0.660,均P＜0.01).糖尿病病程25 ～ 36个月、病程＞ 36个月的患者血糖改善比例与CA199或CEA水平降低比例无关(r分别为0.319和0.439,均P＞0.05).结论糖尿病病程＜24个月的胰腺癌患者的高血糖可能是继发于胰腺癌的—种临床表现,对于新发糖尿病患者需要密切随访以早期诊断胰腺癌.
목적 탐토이선암합병당뇨병환자방료후혈당변화정황급기상관인소.방법 회고성분석료69례Ⅰ～Ⅲ기이선암합병당뇨병환자적림상자료,근거당뇨병병정분조,분석각조적림상특정급경과입체정향방료이후각조환자혈당변화적정황,병분석혈당여종류표지물변화적상관성.결과 당뇨병정＜12개월적이선암환자점39.1％,원고우기타병정적환자.경유효치료후,당뇨병병정＜12개월여병정12 ～24개월환자적혈당개선정황비교,차이무통계학의의(P=0.519);이여병정25 ～36개월화병정＞36개월적환자비교,혈당적개선솔차이균유통계학의의(균P＜0.05).경유효치료후,당뇨병병정＜12개월、병정12～24개월적환자수착CA199혹암배항원(CEA)수평적강저,혈당역유상응적개선,량자정정상관(r분별위0.834화0.660,균P＜0.01).당뇨병병정25 ～ 36개월、병정＞ 36개월적환자혈당개선비례여CA199혹CEA수평강저비례무관(r분별위0.319화0.439,균P＞0.05).결론 당뇨병병정＜24개월적이선암환자적고혈당가능시계발우이선암적—충림상표현,대우신발당뇨병환자수요밀절수방이조기진단이선암.
Objective To investigate the changes of blood glucose in pancreatic cancer patients associated with diabetes mellitus (DM) after radiotherapy and analyze the related factors.Methods Clinical data of 69 cases of stage Ⅰ to Ⅲ pancreatic carcinoma associated with DM were retrospectively analyzed.All patients were divided into four groups according to the history of DM,and the clinical characteristics and blood glucose changes after stereotactic radiotherapy were analyzed.The correlation between blood glucose and serum tumor markers was analyzed.Results No significant differences were found in clinical characteristics of the four groups.The history of DM ＜ 12 months accounted for 39.1％ of the pancreatic cancer patients,much more higher than that of patients with a longer disease course.After radiotherapy,the blood glucose changes were not significantly different between the two groups with DM history ＜ 12 months and 12-24 months (P=0.519),but there were significant differences between the patients with DM history ＜ 12 months and those with DM history 25-36 months and ＞36 months (P ＜ 0.05 for both).After radiotherapy,CA199/CEA was reduced and blood glucose was also improved in the patients with DM history ＜ 12 months and 12-24 months,and the reduction of CA199/CEA showed a significant positive correlation with the improvement of blood glucose (r =0.834 and r =0.660,P ＜ 0.01 for both),however,no significant correlation was found between the two parameters in patients with DM history 25-36 months and ＞36 months (r=0.319 and r=0.439,P＞0.05 for both).Conclusions Hyperglycemia in diabetic patients with a disease course ＜ 24 months might be a clinical manifestation secondarily developed in pancreatic cancer patients.Therefore,patients with new onset diabetes should be closely followed-up for early detection of pancreatic cancer.