不同糖代谢异常状态对胃癌根治术患者预后的预测价值分析  

Prognostic value of different abnormal glucose metabolism in patients undergoing radical gastrectomy for gastric cancer

作　　者：肖海鹏 陆艳军[1] 张凡勇[1] 钟新强 乐逵 刘子君 XIAO Haipeng;LU Yanjun;ZHANG Fanyong;ZHONG Xinqiang;LE Kui;LIU Zijun(Department of Gastrointestinal Surgery,Huanggang Central Hospital,Huanggang 438000,Hubei,China;Department of Gastrointestinal Surgery,The People′s Hospital of Wuhan University,Wuhan 430000,China)

机构地区：[1]黄冈市中心医院胃肠外科,湖北黄冈438000 [2]武汉大学人民医院胃肠外科,湖北武汉430000

出　　处：《西部医学》2023年第11期1684-1687,共4页Medical Journal of West China

基　　金：湖北省自然科学基金项目(2018CFB461)。

摘　　要：目的探讨不同糖代谢状态对胃癌根治术患者预后的预测价值。方法选取2017年1月—2019年1月黄冈市中心医院收治的胃癌患者110例,术前依据口服葡萄糖耐量试验(OGTT)分为糖尿病组23例、糖耐量降低组31例及正常血糖组56例。所有患者均行胃癌根治术,且于术后接受含铂类规范化疗6个疗程。于患者入院开始随访至2022年1月或患者死亡,采用门诊、电话等方式随访,记录患者总生存期和无进展生存期。比较各组临床特征、组织学分型、临床分期、淋巴结转移、无进展生存期和总生存期情况。结果3组性别、年龄、肿瘤直径和体质指数(BMI)比较差异均无统计学意义(P>0.05);3组组织学分型比较差异均无统计学意义(P>0.05);3组TNM分期比较差异无统计学意义(P>0.05);糖尿病组淋巴结转移N1高于糖耐量降低组和正常血糖组(P<0.05);而糖耐量降低组和正常血糖组淋巴结转移N1比较差异无统计学意义(P>0.05);糖尿病组无进展生存期和总生存期短于糖耐量降低组和正常血糖组(P<0.05);糖耐量降低组与正常血糖组无进展生存期和总生存期比较差异均无统计学意义(P>0.05)。结论不同糖代谢状态对胃癌根治术患者预后影响较大,其中伴糖代谢异常患者预后较差。Objective To explore prognostic value of different glucose metabolism in gastric cancer undergoing radical gastrectomy.Methods Gastric cancer 110 patients in Huanggang Central Hospital from January 2017 to January 2019 were selected.According to OGTT,they were divided into 23 cases of DM group,31 cases of impaired glucose tolerance group and 56 cases of normal glucose group.All patients underwent radical gastrectomy and received platinum containing standard chemotherapy for 6 courses.The patients were followed up from admission to January 2022 or died,followed up by outpatient,telephone and other methods,and the overall survival and progression free survival were recorded.The clinical characteristics,histological classification,clinical stage,lymph node metastasis,progression free survival and overall survival were compared.Results The DM group,IGT group and normal blood glucose group gender,age,tumor diameter and body mass index were compared no significant difference(P>0.05).The DM group,IGT group and normal blood glucose group histological typing was compared no significant difference(P>0.05).There was no significant difference in TNM staging among groups(P>0.05).The DM group lymph node metastasis N1 was higher than IGT group and normal blood glucose group(P<0.05)while impaired glucose tolerance group and normal glucose group lymph node metastasis N1 was compared no significant difference(P>0.05).The DM group progression free survival and overall survival were shorter than IGT group and normal glucose group(P<0.05)while impaired glucose tolerance group and normal glucose group progression free survival and overall survival were compared no significant difference(P>0.05).Conclusion Different glucose metabolism status has great influence on the prognosis of gastric cancer patients undergoing radical gastrectomy,and the prognosis of patients with abnormal glucose metabolism is worse.

关 键 词：糖代谢状态 胃癌根治术 预后 

分 类 号：R735.2[医药卫生—肿瘤]