合并2型糖尿病的激素依赖型乳腺癌患者的临床特点及预后

发布时间：2018-11-12 17:23

【摘要】：目的:探讨合并2型糖尿病的激素依赖型乳腺癌患者的临床特点、预后,以及二甲双胍对此类患者预后的影响。方法:收集2012年10月至2017年3月之间广西医科大学第一附属医院合并2型糖尿病的激素依赖型乳腺癌女性患者34例,另通过excel随机数列选取34例与合并2型糖尿病的激素依赖型乳腺癌女性患者同时期住院,且年龄差距±5岁的非合并2型糖尿病的单纯激素依赖型乳腺癌女性患者。此外根据二甲双胍使用情况将合并2型糖尿病激素依赖型乳腺癌患者分为二甲双胍治疗组和非二甲双胍治疗组。分析比较合并2型糖尿病激素依赖型乳腺癌组和单纯激素依赖型乳腺癌组、二甲双胍治疗组和非二甲双胍治疗组患者绝经状态、体重指数、临床特点、预后等是否存在差异。采用SPSS17.0版本进行数据统计分析。连续变量采用t检验,结果用均数±标准差表示;计数资料采用卡方检验或Fisher直接概率法分析;单向有序等级资料采用秩和检验分析。采用Kaplan-Meier法描绘0S曲线及PFS曲线,采用Log-rank法检验两组病人0S及PFS是否存在差异。结果:1、合并2型糖尿病激素依赖型乳腺癌组患者年龄较大,平均年龄为61.26±9.15岁,其中85.29%患者已绝经,与单纯激素依赖型乳腺癌组比较差异无统计学意义(P0.05)。2、合并2型糖尿病激素依赖型乳腺癌组和单纯激素依赖型乳腺癌组体重指数平均数分别为24.56±3.30,24.16±3.82,两组差异无统计学意义(P0.05)。3、合并2型糖尿病激素依赖型乳腺癌组与单纯激素依赖型乳腺癌组肿瘤T分期差异有统计学意义(P=0.029),两组均以T2期为主,合并2型糖尿病激素依赖型乳腺癌组T3-T4期例数明显高于单纯激素依赖型乳腺癌组,其肿瘤T分期更晚。4、合并2型糖尿病激素依赖型乳腺癌组肿瘤临床分期更晚,其临床分期以Ⅲ期为主,单纯激素依赖型乳腺癌组以Ⅱ期为主,两组差异有统计学意义(P=0.010)。5、随访后合并2型糖尿病激素依赖型乳腺癌组与单纯激素依赖型乳腺癌组远处转移、存活状态、生存状态、总生存期、无进展生存期方面差异无统计学意义。但根据两组患者无进展生存曲线,单纯激素依赖型乳腺癌组患者无进展生存期有更长时间的趋势。6、二甲双胍治疗组2型糖尿病病程长于非二甲双胍治疗组,差异有统计学意义(P=0.041)。二甲双胍组无远处转移和死亡病例,非二甲双胍组有2例死亡(其中1例有远处转移),5例远处转移,两组远处转移和存活状态差异无统计学意义。二甲双胍组无进展生存率明显高于非二甲双胍组,两组的生存状态差异有统计学意义(P=0.033)。结论:1、合并2型糖尿病激素依赖型乳腺癌组患者的年龄较大,绝经比例较高,体重指数较大。2、合并2型糖尿病激素依赖型乳腺癌组患者的肿瘤T分期、临床分期更晚。3、二甲双胍改善合并2型糖尿病激素依赖型乳腺癌患者预后。
[Abstract]:Objective: to investigate the clinical features and prognosis of steroid-dependent breast cancer patients with type 2 diabetes mellitus and the influence of metformin on the prognosis of these patients. Methods: from October 2012 to March 2017, 34 female patients with steroid-dependent breast cancer associated with type 2 diabetes in the first affiliated Hospital of Guangxi Medical University were collected. In addition, 34 women with steroid-dependent breast cancer with type 2 diabetes were selected by excel random series in the same period, and the age difference was 卤5 years old, which was simple hormone dependent breast cancer patients without type 2 diabetes mellitus. In addition, patients with type 2 diabetes hormone dependent breast cancer were divided into metformin treatment group and non metformin treatment group according to metformin use. The menopausal status, body mass index (BMI), clinical characteristics and prognosis of patients with type 2 diabetes mellitus with hormone dependent breast cancer and simple hormone dependent breast cancer, metformin treatment and non-metformin treatment were analyzed and compared. SPSS17.0 version is used for statistical analysis. T test is used for continuous variables, the results are expressed as mean 卤standard deviation, chi-square test or Fisher direct probability method is used for counting data, and rank sum test is used for unidirectional order grade data. Kaplan-Meier method was used to depict 0 S curve and PFS curve. Log-rank method was used to test the difference between 0 S and PFS in the two groups. Results: 1. The patients with type 2 diabetes hormone dependent breast cancer were older, the average age was 61.26 卤9.15 years old, and 85.29% of them had menopause. There was no significant difference between steroid dependent breast cancer group and simple hormone dependent breast cancer group (P0.05). The average body mass index (BMI) of type 2 diabetes mellitus with hormone dependent breast cancer and simple hormone dependent breast cancer was 24.56 卤3.30 卤24.16 卤3.82, respectively. There was no significant difference between the two groups (P0.05). There was a statistically significant difference in T stage between steroid-dependent breast cancer with type 2 diabetes mellitus and simple hormone dependent breast cancer group (P0.029). The number of T3-T4 stage cases in type 2 diabetic hormone dependent breast cancer group was significantly higher than that in simple hormone dependent breast cancer group, and the tumor T stage was later than that in type 2 diabetes hormone dependent breast cancer group, and the clinical stage of tumor in type 2 hormone dependent breast cancer group was later than that in simple hormone dependent breast cancer group. Stage 鈪，

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