【导语】2013年第73届美国糖尿病协会科学年会(ADA2013)于6月21日~25日在美国芝加哥隆重举办。在ADA2013年会上，上海交通大学附属第六人民医院顾云娟博士发表一篇壁报“2型糖尿病患者的癌症风险和死亡率增加：在中国上海进行的10年队列研究”，指出T2DM患者的癌症风险和死亡率增加。在治疗T2DM时应对患者进行额外的癌症筛查。以下是医脉通对相关内容的翻译整理。

　　研究旨在评估中国2型糖尿病(T2DM)患者癌症风险和死亡率。

　　研究利用上海糖尿病登记数据库和上海癌症登记及监测系统，共确认12276例T2DM患者，随访时间从2001年12月至2011年7月。利用同一地区人群作为参照，计算性别和年龄分层的标准发病率(SIR)和标准死亡率(SMR)及95%可信区间(CI)。

　　总的癌症风险显著增加，在男性和女性中的SIR分别为3.14(2.73-3.56)和4.29(3.64-4.94)。特定部位的癌症，如肺癌、结肠癌、胃癌、肝癌和胰腺癌的风险显著增加，男性上述癌症的SIRs分别为1.74(1.13-2.34)、3.93(2.61-5.24)、3.13(2.06-4.21)、3.86(2.43-5.29)和5.46(2.69-8.22);女性上述癌症的SIRs分别为5.71(3.74-7.69)、2.56(1.30-3.81)、4.19(2.25-6.13)、3.56(1.15-5.97)和9.00(4.59-13.41)。前列腺癌和乳腺癌的风险显著增加，在男性和女性中的SIR分别是5.48(3.01-7.05)和4.60(2.90-6.31)。总体癌症死亡率显著增加，在男性和女性中的SMR分别为2.27(1.86-2.68)和1.86(1.46-2.26)。男性T2DM患者特定部位癌症如胃癌、肝癌和胰腺癌的死亡率显著增加，SMRs分别为2.14(1.06-3.22)、3.28(1.85-4.71)和4.35(1.88-6.82)。而女性T2DM患者的肺癌和胰腺癌风险显著增加，SMRs分别为4.90(2.90-6.90)和7.76(3.83-11.69)。

　　T2DM患者的癌症风险和死亡率增加。在治疗T2DM时应对患者进行额外的癌症筛查。

【研究摘要】

Increased Cancer and Mortality in Patients with Type 2 Diabetes: A 10-Years Cohort Study in Shanghai China

Yunjuan Gu PhD  Shanghai Jiaotong University Affiliated Sixth People’s Hospital

The aim of the study was to estimate the risk of cancer and mortality in Chinese patients with type 2 diabetes mellitus (T2DM).

Based on the Shanghai Diabetes Registry database linking to the Shanghai Cancer Registry and Surveillance System a total of 12 276 T2DM were defined and followed from December 2001 to July 2011. Gender- and age-stratified standardized incidence ratio (SIR) and mortality ratio (SMR) with 95% confidence interval (CI) were calculated using the same regional population as reference.

The overall cancer risk was found significantly increased with an SIR of 3.14(2.73-3.56) and 4.29(3.64-4.94) in both male and female respectively. As for site-specific cancers risks of lung cancer colorectal cancer gastric cancer liver cancer and pancreatic were significantly elevated with SIRs of 1.74(1.13-2.34) 3.93(2.61-5.24) 3.13(2.06-4.21) 3.86(2.43-5.29) and 5.46(2.69-8.22) in male 5.71(3.74-7.69) 2.56(1.30-3.81) 4.19(2.25-6.13) 3.56(1.15-5.97) and 9.00(4.59-13.41) in female respectively. Risks of prostate cancer and breast cancer were significantly

increased with an SIR of 5.48(3.01-7.05) in male and 4.60(2.90-6.31) in female. Overall cancer mortality was significantly increased with an SMR of 2.27(1.86-2.68) and 1.86(1.46-2.26) in male and female respectively. Regarding site-specific cancer mortality in male T2DM risks of gastric cancer liver cancer and pancreatic cancer were found significantly increased with SMRs of 2.14(1.06-3.22) 3.28(1.85-4.71) and 4.35(1.88-6.82) respectively. In female T2DM risks of lung cancer and pancreatic cancer significantly were increased with SMRs of 4.90(2.90-6.90) and7.76(3.83-11.69) respectively.

The patients with T2DM have excess risks of cancer and mortality. Additional cancer screening should be performed in the treatment of patients with T2DM.