The Analysis Of Prognosis Of Type Ⅰ Endometrial Carcinoma Patients Complicated With Type 2 Diabetes Mellitus

Background:With the social progress going, the rise of people’s living standard, the aged tendency of population and the changed live style have made the prevalence of diabetes mellitus (DM) increase rapidly all around the world, especially type 2 diabetes mellitus(T2DM). According to the statistics, China has ranked the first instead of India with the incidence of DM more than 11% in 2010. Relevant studies have showed that the incidence of malignant neoplasms in T2DM patients is much higher than the normal ones. For example, postmenopasual breast cancer, colorectal cancer, endometrial cancer, liver cancer, pancreatic cancer and NHL (non-hodgkin lymphoma) and so on. What’s worse, it will increase the short-term and long-term morality of the malignant neoplasms. Recently, more and more scientists’attention have been paid to the factors affecting the prognosis of Type I endometrial carcinoma patients complicated with T2DM.Objective:This study was designed to explore the clinical features, pathological characteristics and prognostic factors of the Type I endometrial carcinoma patients who are complicated with T2DM. Then to explore how the factors effect on the prognosis of Type I endometrial carcinoma patients complicated with T2DM.Methods:The retrospective study has enrolled 45 Type I endometrial carcinoma patients complicated with T2DM and 147 Type I endometrial cancer patients without T2DM at the same time. All the patients have accepted responsible treatments based on the international practice guidelines in endometrial cancer.Using T-test to analyze the clinical and pathological features in the T2DM group. Then divide the DM group into metformin and non-metformin groups according to whether to have a regular intake of metformin. Then collect the clinical information retrospectively, compare between the three groups as to the progression-free survival (PFS) and overall survival(OS). Accomplish the survival curves by using the Kaplan-Meier method and compare via log-rank test. P<0.05 is considered statistically significant. With the use of cox multivariate analysis method to perform the effect of metformin on prognosis of Type I endometrial carcinoma patients complicated with T2DM.Result:There is predominance of more elderly, more complicated with hypertension, advanced FIGO stage and high histological grade, infiltrating deeper muscle layer, more lymph node metastasis in the T2DM group. Compared with the non-metformin group, the metformin group showed favorable prognosis with statistically significant shorter PFS and OS. The metformin group has no big difference with the control group. Cox multivariate analysis gives the results:onset age, FIGO staging, histological grade, muscle layer infiltrating, lymph node metastasis, and complicated with DM and intake of metformin could influence the PFS and OS of Type I endometrial carcinoma, what’s more, elder onset age, later FIGO staging, higher histological grade, deeper muscle layer infiltrating, complication with T2DM and more lymph node metastasis have a bad influence on the prognosis of Type I endometrial carcinoma, on the contrary, the intake of metformin gives a good one.Conclusions:The negative facters on the prognosis of Type I endometrial carcinoma patients are complication with T2DM, onset age, FIGO staging, histological grade, muscle layer infiltrating, and lymph node metastasis. Intake of metformin can improve the prognosis of Type I endometrial carcinoma patients complicated with T2DM.