| Background and objective: As the morbidity increases year on year, breast cancer has grown into one of the most common female malignant tumor that accounts for 23%of malignant tumors, as well as one of the key causes of female cancer mortality with death toll accounting for 14% of all cancer deaths [1]; the results of 2010 National Epidemiological Survey showed [2], the diabetes morbidity of adults above 18 years old had climbed to 11.6%. Among them, diabetes morbidity of females saw an increasing trend, up to 11.0%. People living in cities or developed areas and the aged faced even worse situation with much higher morbidity. These two diseases have become the major public health problems worldwide that threaten females’ health and life. However, with the wide application of chemotherapy for breast cancer, more and more attentions have been paid to the changes in blood glucose metabolism and even the induction of diabetes during the chemotherapy. This study is designed to probe into the influence of various factors in adjuvant chemotherapy on the blood glucose of non-diabetic patients with breast cancer, so as to detect high risk group of diabetes to prevent and cure diabetes, as well as to improve the prognosis and survival of patients.Methods: A retrospective analysis has been conducted on the clinical data of patients who had radical mastectomy in the Second Hospital of Dalian Medical University from January 2011 to December 2014. In the 202 cases of breast cancer, all the patients had no history of diabetes and their fasting plasma glucose(FPG) beforechemotherapy were within the normal range. They all underwent radical mastectomy followed by adjuvant chemotherapy. The postoperative pathological results confirmed that they all had non special invasive carcinoma. The FPG before each chemotherapy cycle and related clinical data were collected for retrospective analysis to explore the influence of various factors in the chemotherapy on the blood glucose of patients with breast cancer. The normal FPG after chemotherapy was grouped into the group of normal blood glucose, while the elevated FPG was group into the group of abnormal blood glucose. SPSS17.0 statistical software was applied to analyze the influence of following factors on the blood glucose of both groups: age, body mass index, menstrual conditions, hypertensive, clinical stages, chemotherapy regimens(anthracycline or paclitaxel, anthracycline plus paclitaxel), chemotherapy assisted drugs(diuretics,glucocorticoids).Results: Among the non-diabetic patients with breast cancer in the 202 cases of adjuvant chemotherapy, 58 cases saw higher fasting plasma glucose after chemotherapy,accounting for 28.71%(58/202); 42 cases saw impaired fasting glucose(IFG),accounting for 20.79%(42/202); and 16 cases received definitive diagnosis, accounting for 7.92%(16/202). Single factor analysis showed that the difference was statistically significant(p<0.05) by comparing the group of abnormal blood glucose with the group of normal blood glucose group in age, BMI, menstruation conditions, history of hypertensive, chemotherapy regimens and using glucocorticoids; but in terms of clinical stages, using diuretics, there was no statistically significant difference between the two groups(p>0.05). Multifactor Logistic regression analysis showed that statistically significant indicators included age and using glucocorticoids. The Spearman rank-order correlation analysis showed that the accumulative dosage of glucocorticoids and the level of blood glucose increase were positively correlated(r= 0.369, p= 0.004).Conclusion: 1. Age and using glucocorticoids are independent risk factors for non-diabetic patients with breast cancer to cause IFG or diabetes during postoperative chemotherapy.2. BMI, menopause, history of hypertension and anthracycline combined paclitaxelchemotherapy are relative risk factors for non-diabetic patients with breast cancer to cause IFG or diabetes during postoperative chemotherapy.3. Clinical stages and using diuretics have no effect on fasting plasma glucose increase of on-diabetic breast cancer patients who undergo adjuvant chemotherapy. |
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