包玉倩：T2DM患者應進行癌癥篩查

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為了評估中國2型糖尿病（T2DM）患者中癌癥和死亡率風險，來自上海交通大學附屬第六人民醫院的包玉倩教授及其團隊進行了一項研究，該研究發現T2DM患者有過多的癌癥和死亡率風險。T2DM患者在治療過程中應進行額外的癌癥篩查。

該研究基于上海糖尿病登記數據庫和上海癌癥登記和監測系統鏈接起來，共確認了12276例T2DM患者，并從2001年12月隨訪之2011年7月。利用同一地區人群作為參照，計算性別和年齡分層的95%可信區間（CI）的標準發病率（SIR）和標準死亡率（SMR）。

該研究發現總的癌癥風險顯著增加，男性和女性的SIR分別為3.14（2.73-3.56）和4.29（3.64-4.94）。至于特定部位的癌癥，如肺癌、結腸癌、胃癌、肝癌和胰腺癌的風險顯著提高，在男性，SIRs分別為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分別為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風險顯著增加，在男性，SIR為5.48（3.01-7.05），而在女性，SIR為4.60（2.90-6.31）。總體癌癥死亡率顯著增加，在男性和女性SMR分別為2.27（1.86-2.68）和1.86（1.46-2.26）。至于T2DM男性特定部位癌癥死亡率，發現胃癌、肝癌和胰腺癌風險顯著增加，SMRs分別為2.14（1.06-3.22）、3.28（1.85-4.71）和4.35（1.88-6.82）。而在T2DM女性，肺癌和胰腺癌風險顯著增加，SMRs分別為4.90（2.90-6.90）和7.76（3.83-11.69）。

該研究發現，T2DM患者有過多的癌癥和死亡率風險。T2DM患者在治療過程中應進行額外的癌癥篩查。

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.

編輯： 葛根    來源：丁香園