不同糖代谢水平与膀胱癌病理分级分期相关性的研究-现代医学

不同糖代谢水平与膀胱癌病理分级分期相关性的研究

单位：新疆军区总医院北京路医疗区泌尿外科, 新疆乌鲁木齐 830012

分类号：R737.14

出版年·卷·期（页码）：2020·48·第二期（183-187）

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、HbA₁c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HbA₁c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.

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