| The incidence rates of colorectal cancer (CRC) increased annually in recent years, which seriously do harm to people’s health.It has become the most common malignant tumor of the gastrointestinal tract, ranked the first or second in the world. CRC mortality in2005was significantly increased compared with that in2000, men ranked No.5and women ranked No.6.Recently,it reported that the relationship between CRC and diabetes mellitus (DM) are closed. The possible mechanism is that insulin-like growth factor (IGF) plays a role. Scientists abroad had studied about the relationships between type2DM and CRC. A prospective study of Sweden found that patients of type2DM at a greater risk of CRC. By retrospecting fasting glucose of CRC patients in1274cases, and calculating the prevalence of type2DM, It confirms that in CRC patients the prevalence of type2DM is increased.This study includes two parts:Part I:To figue out the proportion of type2DM in the colorectal cancer patients.Part II:Analysis of clinical characteristics of type2DM combined with colorectal cancerPart I:To figue out the proportion of type2DM in the colorectal cancer patients.Objective:To figue out the proportion of type2DM in the colorectal cancer patients.Methods:Objects of study are1274patients of colorectal cancer which are admitted in the Chengde Medical College Hospital and Chengde Tumor Hospital from January1996to June2009, including colon cancer679cases and595cases of rectal cancer. To analysis the proportion of colorectal cancer patients with type2diabetes sicken by case-control study method.Results:The number of being diagnosed type2DM is78cases, there are124cases that they are diagnosed by fasting glucose, there are116cases that they are abnormal glucose tolerance, Among all the colorectal cancer patients (1274cases), the proportion of type2DM is9.73%, In China in1990, after adjusting the age composition of the fifth population census, the standardization proportion of type2DM is4.03%, that is obviously higher than the third national diabetes among the national census, the result of which is3.21%(P<0.05).Conclusion:The prealence of type2DM of Colorectal cancer patients is increased.Part II:The colorectal cancer with type2DM patients’ tumor location,transfer risk,tumor stage,degree of differentiation and survival rate.Objective:To analyze the colorectal cancer with type2DM patients’tumor location,transfer risk,tumor stage, degree of differentiation and survival rate.Method:Research object includes the observation group:cases of colorectal cancer patients with type2diabetes are124, and the control group:cases of colorectal cancer patients without diabetes are120. By case-control study, to analysis the relationships between the history of type2DM and the metastasis risk of colorectal cancer, the characteristics of tumour stage, the features of tumour site, the differentiation degree of tumor, the influence of radical surgery of type2DM, and the influence of radical surgery of type2DM in observation group the follow-up5-year survival rate.Results: 1. Type2DM patients with colorectal cancer incidence in parts of the observation group,56cases of colon cancer (45.2%) or colon cancer in18cases (32.1%), transverse colon in12cases (21.4%), descending colon in4cases (7.1%), including colon cancer,22cases (39.3%), cancer in68patients (54.8%), disease site was the rectum (50%) and sigmoid colon (17.7%) dominated. Proximal colon (ascending colon, transverse colon) in30cases,24.2%in the distal colon (descending colon, sigmoid colon, rectum) in94cases,75.8%, beyond the main section of the large intestine. Control group,60cases of colon cancer patients (50.0%) or colon cancer in20cases (13.3%), transverse colon in8cases (6.7%), descending colon in4cases (3.3%), sigmoid colon cancer in28cases (23.3%),60cases of rectal cancer (50.0%), disease site was the rectum (50%) and sigmoid colon (23.3%) dominated. Proximal colon (ascending colon, transverse colon) in29cases, accounting for24.2%, distal colon (descending colon, sigmoid colon, rectum)91cases, accounting for75.8%, beyond the main section of the large intestine. Type2diabetes mellitus and non-diabetic patients with colorectal cancer colorectal cancer colorectal cancer patients no significant difference in the distribution sites (P>0.05, not significant).2. To analyze the transfer risk of diabetes history and colorectal cancer. The observation group:cases of colorectal cancer patients with type2diabetes are124, and the control group:cases of colorectal cancer patients without diabetes are120.The transfer rate of diabetes patients of colorectal cancer lymph nodes was (62.9%,78/124),that is higher than those without diabetes (43.33%,52/120), The difference between the two groups was significant.(x2=6.26,P<0.05, Table.4). It shows that the transfer risk is increased,when there is metastasis such as lymph nodes or other tissues and organs in diabetic patients with colorectal cancer (OR=2.21).3. Characteristics of stage of type2DM patients with colorectal cancer.There are118cases of definite stages in124cases of colorectal patients with type2DM patients.The case of Duke’s A is10(8.1%), The case of Duke’s B is34(27.4%), The case of Duke’s C is42(33.9%), The case of Duke’s D is32(25.8%),the rate of Duke’s C, D of the total is59.7%; control group:There are113patients of specific stages in120cases of colorectal cancer without type2diabetes. The case of Duke’s A is15(13.3%), The case of Duke’s B is64(56.6%), The case of Duke’s C is23(20.4%), The case of Duke’s D is11(8.5%), the rate of Duke’s C, D of the total is30.1%. We think that Duke’sC, D are in the late period of colorectal cancer, there were significantly difference between diabetic patients with colorectal cancer and non-diabetic patients with colorectal cancer (P<0.05).4.Type2DM patients with colorectal tumor differentiation in all cases the observation group were Aden carcinoma,52cases in which well-differentiated Aden carcinoma (41.9%), moderately differentiated Aden carcinoma in40cases (32.2%), poorly differentiated Aden carcinoma4cases (3.2%), mutinous Aden carcinoma,16cases (12.9%), papillary carcinoma in2cases (3.2%), and the other8cases were Aden carcinoma, but the specific pathologic type is unknown. Pathological type to highly differentiated Aden carcinoma (74.2%). Control group, all patients were cancer patients, including50cases of Aden carcinoma (41.7%), moderately differentiated Aden carcinoma in38cases (31.7%), poorly differentiated Aden carcinoma in4cases (3.3%),15cases of mutinous adenocarcinoma (12.5%), papillary adenocarcinoma in4cases (3.3%), and the other9cases of adenocarcinoma but the specific pathology is unknown. Pathological type to highly differentiated adenocarcinoma (73.3%). Type2diabetes patients with colorectal cancer in patients with common pathologic type of colorectal cancer was no significant difference (P>0.05, not significant).5. The influence of radical surgery of type2DM In observation group the follow-up5-year survival rate is65.6%(62/93, another31people were unknown, including failed to follow-up and radical surgery failed to reach5years), in the control group5-year survival prevalence rate was79.6%(65/81, another39people were unknown), in both of the two groups the significant is different (P<0.05).Conclusion: 1. Type2DM with colorectal cancer patients’disease location was not significant.2. The risk is increased of which patients with type2DM and colorectal cancer. Tip of type2DM can be risk factors for colorectal cancer patients.3. Colorectal cancer in patients with type2DM in middle and late phases based.4. Type2DM patients with colorectal cancer in patients with no significant pathological differentiation.5. The5-year survival rate after radical surgery is discreased in colorectal cancer merger in patients with type2DM. |
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