Correlation Between Type 2 Diabetes And Advanced Gastric Cancer And Its Lymph Node Metastasis

Objective: In this study,patients with advanced gastric cancer were divided into two groups based on type 2 diabetes mellitus(T2DM).The different characteristics in two groups were analyzed to investigate the potential association between T2 DM and gastric cancer and the possible impact on its lymph node metastasis,in order to establish a foundation for clinical management of patients suffering from T2 DM.Methods: A total of714 patients were finally selected from the gastrointestinal surgery department in our hospital between February 1,2017 and November 30,2021,their general clinical characteristics,preoperative laboratory indices,postoperative pathological data,and the course of diabetes in patients with T2 DM were collected and recorded.Patients were divided into two groups for a case-control study.Results: The crude prevalence of T2 DM in patients included in this study was 28.99%,and the standardized prevalence rate was16.42% after standardization by age composition from the latest census,which was compared with the overall standardized prevalence rate of 12.8%(95% confidence interval12.0% to 13.6%)in the Chinese mainland population published in BMJ in 2020.The results were statistically different(p < 0.05).Univariate analysis of general clinical characteristics and preoperative laboratory indicators revealed statistical differences between two groups in a number of indicators,including age,BMI overweight,smoking,and history of hypertension(p < 0.001,0.004,0.029,and 0.003,respectively)and so on.Further multifactorial logistic regression analysis showed that there were five indicators proved to be different in two groups(p < 0.05).Patients in T2 DM group had deeper infiltration and higher lymph node metastasis rate(p < 0.05).There was a statistical difference in lymph node metastasis between the T2 DM group with T4 infiltration depth and the non-T2 DM group with T2-T3 depth,and a statistical difference in lymph node metastasis between the T2 DM group with T4 infiltration depth and the non-T2 DM group with T4 depth(p < 0.05).Gastric cancer occurs frequently in patients with over 10 years of T2 DM,and there was a difference between patients with diabetes(over 5 years)and those without a history of diabetes(p<0.05).Conclusion: Diabetes is more common in patients with gastric cancer than in the general population,and there may be a link between two conditions.Patients with diabetes are much more like older and have a higher body mass index.Also,they are more likely to have a higher white blood cell count.In pathology,they might have deeper tumor infiltration and a greater likelihood of lymph node metastasis.As the depth of infiltration increases,the biological involvement of diabetes in lymph node metastasis is greater and the risk of lymph node metastasis increases with increasing duration of T2DM.