胰腺癌合并糖尿病患者放疗后血糖变化及相关因素分析  

Analysis of the changes of blood glucose after radiotherapy in pancreatic cancer patients associated with diabetes mellitus and their related factors

作　　者：李勇[1] 潘绵顺[1] 邱书珺[1] 王鹏[1] 邵显军 张丽[1] 

机构地区：[1]武警部队肿瘤放射诊疗中心武警上海市总队医院肿瘤中心,201103

出　　处：《中华肿瘤杂志》2015年第1期33-36,共4页Chinese Journal of Oncology

基　　金：吴阶平医学基金会专项基金（TNB1005）

摘　　要：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一种临床表现，对于新发糖尿病患者需要密切随访以早期诊断胰腺癌。Objective To investigate the changes of blood glucose in pancreatic cancer patients associated with diabetes mallitus （DM） after radiotherapy and analyze the related factors. Methods Clinical data of 69 eases 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.

关 键 词：胰腺肿瘤 糖尿病 血糖 放射疗法 

分 类 号：R735.9[医药卫生—肿瘤]