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伴2型糖尿病乳腺癌患者血糖水平对预后的影响

Effect of blood glucose level on the prognosis of breast cancer patients with type 2 diabetes mellitus
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摘要 目的 探讨血糖水平对伴2型糖尿病乳腺癌患者预后的影响.方法 回顾性分析2005年1月至2009年12月天津医科大学肿瘤医院收治的416例伴2型糖尿病乳腺癌患者的临床资料,根据餐后2 h血糖水平的不同将患者分为<11.1 mmol/L及≥11.1 mmol/L两组,比较两组患者临床病理学特征及生存情况.结果 416例患者中,餐后2 h血糖水平<11.1 mmol/L 310例,≥11.1 mmol/L 106例.两组患者的临床病理学特征差异无统计学意义(均P>0.05).单因素分析结果显示,餐后2 h血糖<11.1 mmol/L与≥11.1 mmol/L患者5年无病生存率、总生存率比较[81.6 %(253/310)比67.0 % (71/106);87.7 %(272/310)比75.5 %(80/106)]差异均有统计学意义(χ2=8.575,P=0.003;χ2=8.722,P=0.003).多因素分析结果显示餐后2 h血糖≥11.1 mmol/L是伴2型糖尿病乳腺癌患者5年无病生存率(HR=1.701,95 % CI 1.110~2.604, P=0.015)及5年总生存率(HR=1.972,95 % CI 1.186~3.279,P=0.009)的独立危险因素.结论 伴2型糖尿病血糖控制差的乳腺癌患者与其5年复发和死亡风险增加.应严格控制血糖水平,以改善伴2型糖尿病乳腺癌患者预后. Objective To investigate the impact of blood glucose level on the prognosis of breast cancer patients with type 2 diabetes mellitus. Methods Clinical data of 416 breast cancer patients with type 2 diabetes mellitus in Tianjin Medical University Cancer Institute and Hospital from January 2005 to December 2009 were analyzed retrospectively. Patients were divided into 2 groups according to the postprandial 2 hours of blood glucose level (〈11.1 mmol/L and ≥11.1 mmol/L). Clinicopathological characteristics and survival of the two groups were compared. Results There were 310 cases of postprandial 2 hours of blood glucose level (〈11.1 mmol/L), and 106 cases of postprandial 2 hours of blood glucose level (≥11.1 mmol/L) in 416 patients. There was no statistical difference in the clinicopathological features between the two groups (both P〉 0.05). Univariate analysis showed that the 5-year disease-free survival rate was 81.6 % (253/310) and 67.0 % (71/106) for patients with postprandial 2 hours of blood glucose level〈11.1 mmol/L and postprandial 2 hours of blood glucose level ≥11.1 mmol/L, respectively (χ2= 8.575, P=0.003). The 5-year overall survival rate was 87.7 % (272/310) and 75.5 % (80/106) for patients with postprandial 2 hours of blood glucose level 〈11.1 mmol/L and postprandial 2 hours of blood glucose level≥11.1 mmol/L, respectively (χ2=8.722, P =0.003). Multivariate analysis showed that 2 hours of blood glucose level≥11.1 mmol/L was an independent risk factor of 5-year disease-free survival rate ( HR=1.701, 95 % CI 1.110-2.604, P= 0.015) and 5-year overall survival rate ( HR= 1.972, 95 % CI 1.186-3.279, P= 0.009) for diabetic breast cancer patients. Conclusion The poor control of blood glucose level for the breast cancer patients complicated with type 2 diabetes is related with the increased risk of 5-year recurrence and death, which requires to strictly control the blood glucose level for improving the prognosis of type 2 diabetic breast cance
作者 张敏 王述进 王欣 Zhang Min, Wang Shujin, Wang Xin (Department of Endocrinology, Ninth Hospital of Xi' an, Xi' an 710054, China ; Department of Breast Cancer 1, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Ministry of Education, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin 300060, China )
出处 《肿瘤研究与临床》 CAS 2018年第6期379-383,共5页 Cancer Research and Clinic
基金 国家自然科学基金(81472472)
关键词 乳腺肿瘤 血糖 糖尿病 2型 预后 Breast neoplasms Blood glucose Diabetes mellitus type 2 Prognosis
作者简介 通信作者:王欣,Email:wangxin@tjmuch.com
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