發(fā)布時(shí)間：2018-11-12 17:23

【摘要】：目的:探討合并2型糖尿病的激素依賴型乳腺癌患者的臨床特點(diǎn)、預(yù)后,以及二甲雙胍對此類患者預(yù)后的影響。方法:收集2012年10月至2017年3月之間廣西醫(yī)科大學(xué)第一附屬醫(yī)院合并2型糖尿病的激素依賴型乳腺癌女性患者34例,另通過excel隨機(jī)數(shù)列選取34例與合并2型糖尿病的激素依賴型乳腺癌女性患者同時(shí)期住院,且年齡差距±5歲的非合并2型糖尿病的單純激素依賴型乳腺癌女性患者。此外根據(jù)二甲雙胍使用情況將合并2型糖尿病激素依賴型乳腺癌患者分為二甲雙胍治療組和非二甲雙胍治療組。分析比較合并2型糖尿病激素依賴型乳腺癌組和單純激素依賴型乳腺癌組、二甲雙胍治療組和非二甲雙胍治療組患者絕經(jīng)狀態(tài)、體重指數(shù)、臨床特點(diǎn)、預(yù)后等是否存在差異。采用SPSS17.0版本進(jìn)行數(shù)據(jù)統(tǒng)計(jì)分析。連續(xù)變量采用t檢驗(yàn),結(jié)果用均數(shù)±標(biāo)準(zhǔn)差表示;計(jì)數(shù)資料采用卡方檢驗(yàn)或Fisher直接概率法分析;單向有序等級資料采用秩和檢驗(yàn)分析。采用Kaplan-Meier法描繪0S曲線及PFS曲線,采用Log-rank法檢驗(yàn)兩組病人0S及PFS是否存在差異。結(jié)果:1、合并2型糖尿病激素依賴型乳腺癌組患者年齡較大,平均年齡為61.26±9.15歲,其中85.29%患者已絕經(jīng),與單純激素依賴型乳腺癌組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2、合并2型糖尿病激素依賴型乳腺癌組和單純激素依賴型乳腺癌組體重指數(shù)平均數(shù)分別為24.56±3.30,24.16±3.82,兩組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3、合并2型糖尿病激素依賴型乳腺癌組與單純激素依賴型乳腺癌組腫瘤T分期差異有統(tǒng)計(jì)學(xué)意義(P=0.029),兩組均以T2期為主,合并2型糖尿病激素依賴型乳腺癌組T3-T4期例數(shù)明顯高于單純激素依賴型乳腺癌組,其腫瘤T分期更晚。4、合并2型糖尿病激素依賴型乳腺癌組腫瘤臨床分期更晚,其臨床分期以Ⅲ期為主,單純激素依賴型乳腺癌組以Ⅱ期為主,兩組差異有統(tǒng)計(jì)學(xué)意義(P=0.010)。5、隨訪后合并2型糖尿病激素依賴型乳腺癌組與單純激素依賴型乳腺癌組遠(yuǎn)處轉(zhuǎn)移、存活狀態(tài)、生存狀態(tài)、總生存期、無進(jìn)展生存期方面差異無統(tǒng)計(jì)學(xué)意義。但根據(jù)兩組患者無進(jìn)展生存曲線,單純激素依賴型乳腺癌組患者無進(jìn)展生存期有更長時(shí)間的趨勢。6、二甲雙胍治療組2型糖尿病病程長于非二甲雙胍治療組,差異有統(tǒng)計(jì)學(xué)意義(P=0.041)。二甲雙胍組無遠(yuǎn)處轉(zhuǎn)移和死亡病例,非二甲雙胍組有2例死亡(其中1例有遠(yuǎn)處轉(zhuǎn)移),5例遠(yuǎn)處轉(zhuǎn)移,兩組遠(yuǎn)處轉(zhuǎn)移和存活狀態(tài)差異無統(tǒng)計(jì)學(xué)意義。二甲雙胍組無進(jìn)展生存率明顯高于非二甲雙胍組,兩組的生存狀態(tài)差異有統(tǒng)計(jì)學(xué)意義(P=0.033)。結(jié)論:1、合并2型糖尿病激素依賴型乳腺癌組患者的年齡較大,絕經(jīng)比例較高,體重指數(shù)較大。2、合并2型糖尿病激素依賴型乳腺癌組患者的腫瘤T分期、臨床分期更晚。3、二甲雙胍改善合并2型糖尿病激素依賴型乳腺癌患者預(yù)后。
[Abstract]:Objective: to investigate the clinical features and prognosis of steroid-dependent breast cancer patients with type 2 diabetes mellitus and the influence of metformin on the prognosis of these patients. Methods: from October 2012 to March 2017, 34 female patients with steroid-dependent breast cancer associated with type 2 diabetes in the first affiliated Hospital of Guangxi Medical University were collected. In addition, 34 women with steroid-dependent breast cancer with type 2 diabetes were selected by excel random series in the same period, and the age difference was 鹵5 years old, which was simple hormone dependent breast cancer patients without type 2 diabetes mellitus. In addition, patients with type 2 diabetes hormone dependent breast cancer were divided into metformin treatment group and non metformin treatment group according to metformin use. The menopausal status, body mass index (BMI), clinical characteristics and prognosis of patients with type 2 diabetes mellitus with hormone dependent breast cancer and simple hormone dependent breast cancer, metformin treatment and non-metformin treatment were analyzed and compared. SPSS17.0 version is used for statistical analysis. T test is used for continuous variables, the results are expressed as mean 鹵standard deviation, chi-square test or Fisher direct probability method is used for counting data, and rank sum test is used for unidirectional order grade data. Kaplan-Meier method was used to depict 0 S curve and PFS curve. Log-rank method was used to test the difference between 0 S and PFS in the two groups. Results: 1. The patients with type 2 diabetes hormone dependent breast cancer were older, the average age was 61.26 鹵9.15 years old, and 85.29% of them had menopause. There was no significant difference between steroid dependent breast cancer group and simple hormone dependent breast cancer group (P0.05). The average body mass index (BMI) of type 2 diabetes mellitus with hormone dependent breast cancer and simple hormone dependent breast cancer was 24.56 鹵3.30 鹵24.16 鹵3.82, respectively. There was no significant difference between the two groups (P0.05). There was a statistically significant difference in T stage between steroid-dependent breast cancer with type 2 diabetes mellitus and simple hormone dependent breast cancer group (P0.029). The number of T3-T4 stage cases in type 2 diabetic hormone dependent breast cancer group was significantly higher than that in simple hormone dependent breast cancer group, and the tumor T stage was later than that in type 2 diabetes hormone dependent breast cancer group, and the clinical stage of tumor in type 2 hormone dependent breast cancer group was later than that in simple hormone dependent breast cancer group. Stage 鈪，

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