2型糖尿病对结直肠癌患者肿瘤标记物、临床病理及预后的影响  

The effect of type 2 diabetes on tumor markers,clinicopathology and prognosis in patients with colorectal cancer

作　　者：严虹霞[1] 王晓娟[2] 张毅勋[3] Hongxia Yan;Xiaojuan Wang;Yixun Zhang(Department of Pharmacy,Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Pathology,Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Colorectal and Anal Surgery,Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院/中国医学科学院山西医院/山西医科大学附属肿瘤医院药学部,太原030013 [2]山西省肿瘤医院/中国医学科学院山西医院/山西医科大学附属肿瘤医院病理科,太原030013 [3]山西省肿瘤医院/中国医学科学院山西医院/山西医科大学附属肿瘤医院结直肠外科,太原030013

出　　处：《中华结直肠疾病电子杂志》2024年第6期483-487,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：山西省科技厅自然科学研究面上项目(No.202203021221280);山西省卫生健康委一般项目(No.2020063)。

摘　　要：目的探讨2型糖尿病(T2DM)对结直肠癌患者肿瘤标记物、临床病理及预后的影响。方法收集2018年1月至2019年12月在山西省肿瘤医院结直肠外科住院治疗的结直肠癌患者的病例资料,按照纳入标准及是否合并2型糖尿病,分为结直肠癌合并2型糖尿病组(合并组)和单纯结直肠癌组(对照组)。采用倾向性评分匹配法按1:1匹配后,共匹配96对。比较两组患者肿瘤标志物、错配修复蛋白、Ki67、p53及远期预后情况。结果匹配前两组患者年龄差异有统计学意义(t=5.117,P<0.05)。匹配后两组患者一般资料差异均无统计学意义(P>0.05)。合并组癌胚抗原(CEA)、CA19-9、CA242、CA724、CA50及组织多肽特异性抗原(TPS)均高于对照组,且差异有统计学意义(P<0.05)。与对照组相比,合并组易发生错配修复缺陷(χ^(2)=0.245,P=0.805),Ki67高表达较多(χ^(2)=0.273,P=0.795),p53易发生突变(χ^(2)=2.602,P=0.142),但差异均无统计学意义(P>0.05)。合并组5年生存率均明显低于对照组(52.27%vs.75.51%,χ^(2)=4.149,P=0.032),差异有统计学意义。结论2型糖尿病使结直肠癌患者肿瘤标志物明显升高,肿瘤增殖活性增强,且对该类患者远期预后造成不良影响。Objective To investigate the effect of type 2 diabetes mellitus(T2DM)on tumor markers,clinicopathology and prognosis in patients with colorectal cancer.Methods The hospitalization information of patients with colorectal cancer who were hospitalized in the colorectal surgery department of Shanxi Cancer Hospital from January 2018 to December 2019 was collected.According to the inclusion criteria and whether they were combined with type 2 diabetes,they were divided into colorectal cancer combined with type 2 diabetes group(combined group)and simple colorectal cancer group(control group).After 1:1 matching by propensity score matching method,a total of 96 pairs were matched.Serum tumor markers,mismatch repair protein deletion,high expression of Ki67,positive rate of p53 and long-term prognosis were compared between the two groups.Results There was significant difference in age between the two groups before matching(t=5.117,P<0.05).There was no significant difference in general data between the two groups after matching(P>0.05).The carcinoembryonic antigen(CEA),CA19-9,CA242,CA724,CA50 and tissue polypeptide specific antigen(TPS)in the combined group were higher than those in the control group,and the differences were statistically significant(P<0.05).Compared with the control group,the combined group was prone to mismatch repair defects(χ^(2)=0.245,P=0.805),high expression of Ki67(χ^(2)=0.273,P=0.795),and p53 mutation(χ^(2)=2.602,P=0.142),but the difference was not statistically significant(P>0.05).The 5-year survival rate of the combined group was significantly lower than that of the control group(52.27%vs.75.51%,χ^(2)=4.149,P=0.032),the difference was statistically significant(P<0.05).Conclusion Type 2 diabetes mellitus significantly increases serum tumor markers and tumor proliferation activity in patients with colorectal cancer,and has a negative impact on the long-term prognosis of these patients.

关 键 词：2型糖尿病 结直肠肿瘤 肿瘤标志物 错配修复蛋白 KI67 p53 

分 类 号：R73[医药卫生—肿瘤]