包玉倩：T2DM患者应进行癌症筛查

为了评估中国2型糖尿病（T2DM）患者中癌症和死亡率风险，来自上海交通大学附属第六人民医院的包玉倩教授及其团队进行了一项研究，该研究发现T2DM患者有过多的癌症和死亡率风险。T2DM患者在治疗过程中应进行额外的癌症筛查。

该研究基于上海糖尿病登记数据库和上海癌症登记和监测系统链接起来，共确认了12276例T2DM患者，并从2001年12月随访之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95%可信区间（CI）的标准发病率（SIR）和标准死亡率（SMR）。

该研究发现总的癌症风险显著增加，男性和女性的SIR分别为3.14（2.73-3.56）和4.29（3.64-4.94）。至于特定部位的癌症，如肺癌、结肠癌、胃癌、肝癌和胰腺癌的风险显著提高，在男性，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）；而在女性，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，SIR为5.48（3.01-7.05），而在女性，SIR为4.60（2.90-6.31）。总体癌症死亡率显著增加，在男性和女性SMR分别为2.27（1.86-2.68）和1.86（1.46-2.26）。至于T2DM男性特定部位癌症死亡率，发现胃癌、肝癌和胰腺癌风险显著增加，SMRs分别为2.14（1.06-3.22）、3.28（1.85-4.71）和4.35（1.88-6.82）。而在T2DM女性，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）。

该研究发现，T2DM患者有过多的癌症和死亡率风险。T2DM患者在治疗过程中应进行额外的癌症筛查。

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.

编辑： 葛根    来源：丁香园