高血糖与胆囊癌浸润转移的关系

发布时间：2018-04-05 22:32

本文选题：高血糖　切入点：胆囊癌　出处：《中华肿瘤防治杂志》2016年14期

【摘要】：目的流行病学调查显示糖尿病患者中胆囊癌的发病率显著增高。本研究通过对胆囊癌高血糖组和胆囊癌血糖正常组临床病理特征的分析和血清学指标的检测,探讨高血糖与胆囊癌浸润转移的关系。方法选取2010-04-01-2015-04-15广西医科大学第一附属医院诊治的住院胆囊癌患者233例,按照空腹血糖分为血糖正常组128例(3.9mmol/L≤血糖6.1mmol/L)和高血糖组105例(≥6.1mmol/L)。分别比较两组患者的肿瘤相关血清学指标(AFP、CEA、CA125、CA19-9、CA15-3)和各项临床病理特征(肿瘤分化程度、淋巴结转移、静脉癌栓、远处脏器转移、Nevein分期)。结果胆囊癌高血糖组与胆囊癌血糖正常组相比,高血糖组低分化或未分化癌发生的比率,以及淋巴结转移、静脉癌栓和远处脏器转移发生的比率均高于血糖正常组,差异有统计学意义,χ2分别为11.288、9.117、14.224和11.797,均P0.05;高血糖组高分化癌发生的比率低于血糖正常组,差异有统计学意义,χ2=25.010,P0.05;高血糖组和血糖正常组在中分化癌发生的比率及Nevein分期Ⅰ或Ⅱ期(即早期)所占比率差异无统计学意义,χ2=0.023,P0.05;高血糖组和血糖正常组血清中甲胎蛋白(alpha fetoprotein,AFP)、癌胚抗原(carcino-embryonic antigen,CEA)、糖蛋白抗原CA125、糖蛋白抗原CA19-9、糖蛋白抗原CA15-3的浓度均差异无统计学意义,Z值分别为-0.379、-1.125、-1.360、-1.391和-1.701,均P0.05。对胆囊癌血糖正常/异常的相关因素进行Logistic回归分析,纳入方程的自变量有高分化、中分化、低分化和淋巴结转移。其中低分化和淋巴结转移是危险因素,与胆囊癌伴高血糖正相关,但由于OR值较小,是低度相关危险因素。结论高血糖能促进胆囊癌的浸润和转移,尽早将血糖控制在正常范围,将改善合并高血糖的胆囊癌患者的预后。
[Abstract]:Objective to investigate the incidence of gallbladder carcinoma in diabetic patients.In this study, the relationship between hyperglycemia and invasion and metastasis of gallbladder carcinoma was studied by analyzing the clinicopathological characteristics of hyperglycemia and normal blood glucose of gallbladder carcinoma.The tumor related serological parameters of the two groups were compared, and the clinicopathological features (tumor differentiation, lymph node metastasis, venous tumor thrombus, distant organ metastasis and Nevein staging) were compared.Results the rate of hypodifferentiated or undifferentiated carcinoma, lymph node metastasis, venous tumor thrombus and distant organ metastasis in hyperglycemia group were higher than those in normal blood glucose group.The difference was statistically significant (蠂 ~ 2 = 11.288 ~ 9.117 ~ 14.224 and 11.797, respectively, P < 0.05). The incidence of well-differentiated cancer in hyperglycemia group was lower than that in normal blood glucose group.The correlation factors of normal / abnormal blood glucose in gallbladder carcinoma were analyzed by Logistic regression analysis. The independent variables included high differentiation, middle differentiation, low differentiation and lymph node metastasis.Among them, low differentiation and lymph node metastasis were risk factors, which were positively correlated with hyperglycemia in gallbladder carcinoma, but low risk factors due to low OR value.Conclusion hyperglycemia can promote the invasion and metastasis of gallbladder carcinoma, and control the blood sugar in normal range as soon as possible, which will improve the prognosis of patients with gallbladder carcinoma complicated with hyperglycemia.
【作者单位】：广西医科大学第一附属医院病理科;广西医科大学第一附属医院内分泌代谢病科;
【基金】：国家自然科学基金(81060070) 广西壮族自治区卫生厅自筹经费项目(Z2014056) 广西医科大学“未来学术之星”大学生课外创新计划(WLXSZX1564)
【分类号】：R735.8;R587.1

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