不同糖代谢水平与膀胱癌病理分级分期相关性的研究  

Correlation of different glucose metabolism levels with tumor grade and stage in patients with primary bladder carcinoma

作　　者：周桂升 甘之录 武阳 ZHOU Guisheng;GAN Zhilu;WU Yang(Department of Urology,474 Hospital of the PLA,Unumgi 830012,China)

机构地区：[1]新疆军区总医院北京路医疗区泌尿外科,新疆乌鲁木齐830012

出　　处：《现代医学》2020年第2期183-187,共5页Modern Medical Journal

摘　　要：目的:观察不同糖代谢水平膀胱癌患者的病理分级分期,并分析糖代谢水平与病理分级分期的相关性。方法:选取膀胱癌患者230例,根据75 g OGTT结果分为DM组89例、IGR组72例及NGT组69例,比较各组临床资料及肿瘤分期和病理分级。采用Cox回归模型多因素分析评价肿瘤分期和病理分级与其他指标的关系。结果:(1)DM组和IGR组BMI、FPG、2 h PG、FIns、Hb A1c及HOMA-IR均高于NGT组,IGR组BMI、FPG、2 h PG、HbA1c及HOMA-IR均高于NGT组(P<0.05或P<0.01);(2)在病理分期和分级中,DM组T1和病理分级低级别患者所占比例低于NGT组和IGR组,T3、T4及病理分级高级别患者所占比例高于NGT组和IGR组(P<0.05或P<0.01);(3)Cox多因素分析结果显示,年龄、BMI及Hb A1c是膀胱癌分期和病理分级进展共同的风险因素(P<0.05)。结论:糖尿病合并膀胱癌患者肿瘤分级和分期较高;高龄、肥胖、血糖控制差可能增加膀胱癌的病理分级和分期。Objective:To investigate the correlation of different glucose metabolism levels with tumor grade and stage in patients with primary bladder carcinoma.Methods:The enrolled 230 cases with primary bladder carcinoma,according to 75 g OGTT,were divided into DM(diabetes mellitus)group(n=89),IGR group(n=72)and NGT group(n=69).Clinical data,tumor grade and stage among the three groups were analyzed and compared,respectively.Cox regression multivariate was applied to evaluate the relationship between tumor grade and stage and other indexes.Results:(1)BMI,FPG,2 h PG,FIns,HbA1c and HOMA-IR in DM group and IGR group were both higher than those in NGT group,and BMI,FPG,2 h PG,HbA1c and HOMA-IR in IGR group were higher compared to NGT group(P<0.05 or P<0.01);(2)As to tumor grade and stage,the proportion of T1 stage and low-grade,and those of T3 stage,T4 stage and high-grade in DM group were higher than those in NGT group and in IGR group,respectively(P<0.05 or P<0.01);(3)Cox regression multivariate showed that age,BMI and HbA1c were the common risk factors for the progression of tumor grade and stage in patients with bladder carcinoma(P<0.05).Conclusion:DM patients with bladder cancer have higher tumor grade and stage;In addition,certain risk factors,such as advanced-age,obesity and poor blood sugar control may increase the tumor grade and stage.

关 键 词：糖代谢水平 膀胱肿瘤 肿瘤分级分期 相关性 

分 类 号：R737.14[医药卫生—肿瘤]