| Objective:The present study was conducted to analysis of clinical cases,to summarize clinical characteristics,laboratory indicators,pathological type,location,staging,therapy of type 2 diabetes mellitus patients with lung cancer,and the effect of type 2 diabetes mellitus(T2DM)on prognosis in small cell lung cancer(SCLC)patients,to improve the physicians understanding of T2 DM with lung cancer.Methods: We collected 256 cases of lung cancer of the first hospital of Lanzhou University,which were diagnosed through bronchoscopy or(and)by percutaneous biopsy under CT guidance or(and)surgical biopsy from January 2012 to November 2016,169 patients with lung cancer as the control group,87 patients with T2 DM complicated with lung cancer as the observation group.Data were analyzed by SPSS 21.0 statistical software.Results: T2 DM complicated with lung cancer group's age was 62.18±8.78 years,lung cancer group's age was 57.44±10.00 years,there was significant difference in age(P =0.000).Body mass index in T2 DM complicated with lung cancer group was significantly higer than in lung cancer group(23.70±3.06kg/m2 vs 22.57±3.39kg/m2,P =0.000).In T2 DM complicated with lung cancer group 38 cases' diabetes duration is between 2 years to 5 years(44%),26 cases' diabetes duration is ?2 years(30%),23 cases' diabetes duration is ?5 years(26%),the lung cancer often occurs in diabetes duration between 2 years to 5 years.Previous medical history:Two groups in hypertension history and lung disease have significant difference(P =0.000?0.020).Clinical manifestations: There was significant difference in thoracodorsal pain(P =0.041)between two groups.Laboratory indicators:High density lipoprotein in T2 DM complicated with lung cancer group was significantly lower than in lung cancer group(1.00±0.24 mmol/l vs 1.11±0.29mmol/l),fasting blood glucose and triglyceride in T2 DM complicated with lung cancer group were significantly higher than in lung cancer group(9.08±3.80mmol/l vs 5.11±0.57mmol/l,1.64±1.10mmol/l vs 1.43±1.21mmol/l).There was a statistical difference in positive rate of CEA between two groups(P =0.039).Pathological types:In T2 DM complicated with lung cancer group included squamous cell carcinoma 18 cases,adenocarcinoma 36 cases,small cell carcinoma 28 cases and other pathological type 5 cases;In lung cancer group every pathological type respectively included 46 cases,71 cases,43 cases,9 cases,there was no significant difference in pathological types,in two groups the common pathological type is adenocarcinoma.Differentiation degree:2 cases were well differentiated,29 cases were moderately differentiated,40 cases were poorly differentiated,16 cases were undifferentiated in T2 DM complicated with lung cancer group;In lung cancer group,these differentiation degree respectively was 13 cases,66 cases,59 cases,31 cases.Location:Among T2 DM complicated with lung cancer group of 25 cases in right upper lobe,13 cases in right middle lobe,16 cases in right lower lobe,16 cases in left upper lobe,17 cases in left lower lobe,while among lung cancer group various parts respectively is 32 cases,28 cases,34 cases,41 cases,34 cases.Clinical staging:Fristly based on the type of pathological,the patients were classified into 2 groups: SCLC and NSCLC;Secondly based on whether patients have diabetes mellitus or not,they were classified into group DM and group non-DM:(1)According to the results from NSCLC,Stage I included 0 vs 1 case,Stage ? included 9 cases vs 27 cases,Stage ? included 22 cases vs30 cases,Stage ? included 28 cases vs 68 cases,corresponding to group DM and non-DM,there was no significant difference in clinical staging of NSCLC;(2)According to the results from SCLC,limited stage included 5 cases(17.86%)vs 18 cases(41.86%),extensive stage included 23 cases(82.14%)vs 25 cases(58.14%),corresponding to group DM and group non-DM,there was significant difference in clinical staging of SCLC between group DM and group non-DM.Therapy choice:The majority of patients were treated with chemotherapy.Prognosis:Univariate survival analysis showed that TT,LDH,CEA,CA125 and clinical stage were closely associated with SCLC patients' overall survival time(P =0.047?0.000?0.048?0.037?0.001),while T2 DM wasn't associated with SCLC patients' overall survival time(P =0.153).Based on multivariate Cox regression analysis,LDH level and clinical stage were independent predictors of survival in SCLC patients(The medium survival time was 15 months in limited stage,while 11 months in extensive stage).Conclusion: The T2 DM complicated with lung cancer group's age is higer than control group's,the lung cancer often occurs in diabetes duration between 2 years to 5 years.The T2 DM complicated with lung cancer group often associated with hypertension and pulmonary disease,BMI in T2 DM complicated with lung cancer group was significantly higher than in lung cancer group.The patients had no specific clinical manifestations,in thoracodorsal pain the T2 DM complicated with lung cancer group was more obvious than the lung cancer group.Fasting blood glucose and triglyceride in T2 DM complicated with lung cancer group were higher than those of controls,but in high density lipoprotein was lower than those of controls.Adenocarcinoma is common in all patients,always occurred in upper lobe lung.Most of the T2 DM complicated with lung cancer patients were of poorly differentiated,while in lung cancer group most of patients were of moderately differentiated.In the type of NSCLC,most of patients were of stage ?;While in the type of SCLC,the proportion of extensive disease patients in T2 DM complicated with SCLC group was significantly higher than in SCLC group.Chemotherapy was the main treatment method.T2 DM wasn't associated with SCLC patients overall survival time,while LDH level and clinical stage were independent predictors of survival in SCLC patients. |
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