2型糖尿病与肾透明细胞癌相关性的临床研究  

Clinical research on the correlations between type 2 diabetes mellitus and renal clear cell carcinoma

作　　者：宋希双[1] 范博[1] 马驰[1] 于振龙[1] 白珊珊[1] 张展[1] 赵惠[1] 朱鑫卿[1] 何顺亮[1] 陈峰[1] 陈奇伟[1] 杨德勇[1] 王建伯[1] 李先承[1] 

机构地区：[1]大连医科大学附属第一医院泌尿外科,116011

出　　处：《中华外科杂志》2013年第7期627-630,共4页Chinese Journal of Surgery

基　　金：辽宁省教育厅高等学校科研项目计划资助项目（2009A198）;辽宁省科技厅科学技术计划资助项目（2011225013）

摘　　要：目的 探讨2型糖尿病与肾透明细胞癌的相关性.方法 收集2008年1月至2012年12月264例肾透明细胞癌患者的临床资料,以同期非肿瘤、非泌尿系统及非激素代谢异常类疾病患者400例为对照组,比较2组患者糖尿病的发生率、糖尿病病程与肾透明细胞癌的关系;分析264例肾透明细胞癌患者中伴糖尿病者与不伴糖尿病者的临床、实验室及病理学指标的差异.结果 肾透明细胞癌患者和对照组患者糖尿病发生率分别为19.7％和12.8％,两组差异有统计学意义（x2=5.86,P ＜0.05,OR=1.68）;糖尿病病程2～4年的比例分别为4.9％和1.7％,差异有统计学意义（x2=5.49,P＜0.05,OR =2.91）,男性糖尿病者与非糖尿病者相比,发生肾癌的风险增高（OR=1.86,95％ CI：1.09 ～3.15）.264例肾透明细胞癌患者根据是否伴有糖尿病分为糖尿病组（52例）和非糖尿病组（212例）,2组肿瘤最大径分别为（4.9 ±2.3）cm和（4.2 ±2.1）cm,差异有统计学意义（t=1.96,P＜0.05）;而年龄、性别、肿瘤部位比较差异无统计学意义（P＞0.05）.糖尿病组血肌酐[（72±20） μmol/L]、尿素氮[（7.1 ±2.1）mmol/L]高于非糖尿病组,差异有统计学意义（=2.34、1.47,P＜0.05）.2组患者中高分化透明细胞癌所占比例分别为80.8％和81.1％,差异有统计学意义（x2=4.23,P＜0.05）;Ⅱ期肾癌所占比例分别为25.0％和27.8％,差异有统计学意义（x2=4.08,P ＜0.05）.结论 2型糖尿病与肾透明细胞癌关系密切,可能是肾癌的危险因素之一;中老年糖尿病患者出现腰部不适或血尿时,应行肾脏B超检查以免延误诊治,改善患者预后.Objective To investigate the relationship between renal clear cell carcinoma and type 2 diabetes mellitus （DM）. Methods Two hundreds and sixty-four patients with renal clear cell carcinoma and four hundred controls who suffered from non-urinary system, non-neoplastic or non-hormone-related disorders, were enrolled from January 2008 to December 2012. The incidence of diabetes between the 2 groups and the relationship between renal clear cell carcinoma and duration of diabetes were compared, moreover, renal clear cell carcinoma patients with DM were compared with patients without DM for their clinical features, laboratory examinations and histological characteristics. Results The comparison of renal clear cell carcinoma group and control group： the incidence of DM in the two groups were 19. 7% and 12. 8% respectively, and the difference was significant （~2 =5.86, P 〈0. 05, OR = 1.68）. In the renal clear cell carcinoma group, the proportion of patients with DM diagnosed within 2-4 years was 4. 92%, which were significant higher than those in the control group 1.70% （ X2 = 5.49, P 〈 0. 05, OR = 2. 91 ）.And men with diabetes had high occurrence risk 86% of renal clear cell carcinoma （ OR = 1.86, 95% CI： 1.09-3.15 ）. The comparison of diabetes patients subgroup and non-diabetic patients subgroup in renal clear cell carcinoma group： in respect of clinical features, greatest tumor diameter in the two subgroups were （4. 9 ± 2. 3） cm and （ 4. 2 ± 2. 1 ） cm respectively, and the difference was significant （ t = 1.96, P 〈 0. 05 ）. However, there was no significant difference in terms of age, gender and cancer location between the two subgroups （ P 〉 0. 05 ）. In respect of laboratory examinations, serum creatinine in the two subgroups were （72 ±20） μmol/L and （65 ± 17）μmol/L, and the difference was significant （t =2. 34, P 〈0. 05） ; serum urea nitrogen in the 2 subgroups were （ 7.1 ± 2. 1 ） mmol/L and （ 6. 0 ± 1.5 ） mmol/L respectively, and the differ

关 键 词：糖尿病 2型 肾肿瘤 模型 统计学 

分 类 号：R737.11[医药卫生—肿瘤]