| Objective: To investigate the relationship between type Ⅱ diabetes mellitus(T2DM)and cervical lymph node metastasis of oral squamous cell carcinoma(OSCC)by retrospectively analyzing the clinical data of 119 cases of oral squamous cell carcinoma(OSCC)patients diagnosed by pathological examination in our hospital,and to explore the possible underlying mechanism of the relationship between T2 DM and cervical lymph node metastasis of OSCC and provide some reference for the treatment of type Ⅱ diabetes with oral squamous cell carcinoma in clinical practice,improve the clinical diagnosis and treatment of patients,increase the survival rate and reduce the recurrence rate of patients.Methods: A total of 119 patients with oral squamous cell carcinoma,including 24 patients with type Ⅱ diabetes mellitus and 95 patients without diabetes mellitus,who were hospitalized in the 900 th Hospital of the Chinese People’s Liberation Army Joint Logistic Support Force from December 2011 to December 2018 and met the inclusion and exclusion criteria were collected,summarized and collated by referring to the archived case data and outpatient data and telephone follow-up.119 samples were divided into 24 cases with type Ⅱ diabetes(hereinafter referred to as diabetes group)and95cases without diabetes.In the type Ⅱ diabetes group,Fisher’s exact probability method was used to compare and analyze the relationship between the course of diabetes and cervical lymph node metastasis of oral squamous cell carcinoma.Chi-square test was used to analyze and compare the difference in cervical lymph node metastasis rate of oral squamous cell carcinoma between the two groups and verify the relationship between the two.Univariate chi-square test was also used to compare and analyze the clinicopathological factors that may be associated with cervical lymph node metastasis of oral squamous cell carcinoma,including age,gender,diabetes,depth of invasion,pathological grade,T stage,primary tumor growth site and growth type.Finally,the above significant risk factors after statistical test analysis were included in binary logistic regression analysis,so as to obtain the independent risk factors of cervical lymph node metastasis of oral squamous cell carcinoma,in order to examine the degree of influence of type Ⅱ diabetes mellitus and other risk factors on cervical lymph node metastasis of oral squamous cell carcinoma.Results: 1.A total of 119 OSCC patients met the inclusion and exclusion criteria of this study,including 72 male patients and 47 female patients.The male to female ratio was about 1.53:1,the age distribution was from 27 to 85 years,the middle age was 58 years,and the average age was 57.69 ± 11.04 years.Of the 119 patients,a total of 24 patients had diabetes,and the prevalence of type Ⅱ diabetes mellitus was about 20.17%(24/119).Of the 119 patients,a total of 51 patients developed cervical lymph node metastasis,with a metastasis rate of approximately 42.86%.Among them,there were 95 patients in the non-diabetic group,and 36 patients developed cervical lymph node metastasis,with a metastasis rate of about 37.89%.There were 24 patients in the type Ⅱ diabetes group,and 15 patients developed cervical lymph node metastasis,with a metastasis rate of approximately 62.50%.The duration of diabetes was 1 ～ 8 years,the duration of diabetes was 3 years,and the average duration of diabetes was 3.63 ± 1.79 years.Among the patients with duration of diabetes for 3 years or less than 3 years,6 patients developed cervical lymph node metastasis,the cervical lymph node metastasis rate was about 46.15%(6/13),and among the patients with duration of diabetes for more than 3years,9 patients developed cervical lymph node metastasis,the cervical lymph node metastasis rate was about 81.81%(9/11).Although there was no significant difference between the two groups(P > 0.05),the cervical lymph node metastasis rate was higher in patients with duration of diabetes for more than 3 years than in patients with duration of diabetes for 3 years or less than 3 years,the ratio of the two is as high as 1.76: 1.2.In this study,the cervical lymph node metastasis rate was 62.50%(15/24)in the type Ⅱ diabetic group and 37.89%(36/95)in the non-diabetic group.By chi-square test,OR = 2.731 > 1,P < 0.05,and there was a significant difference between the two groups in the cervical lymph node metastasis rate.3.In this study,among the factors associated with cervical lymph node metastasis of oral squamous cell carcinoma by univariate analysis,chi-square test was conducted to investigate the relationship between gender,age,primary tumor growth site,tumor growth type and cervical lymph node metastasis of oral squamous cell carcinoma,the difference was not statistically significant(P > 0.05).The relationship between depth of invasion,pathological grade,T stage,diabetes and cervical lymph node metastasis of oral squamous cell carcinoma was tested by chi-square test,the difference was statistically significant(P < 0.05).After including depth of invasion,pathological grade,T stage and diabetes into binary logistic regression analysis,only the pathological grade,T stage and depth of invasion were statistically significant by logistic regression analysis(P<0.05),while diabetes indicators showed P > 0.05 by logistic regression analysis,where the difference could not be considered statistically significant.Conclusions: 1.Type Ⅱ diabetes mellitus may be a risk factor for cervical lymph node metastasis of oral squamous cell carcinoma,but it cannot be an independent risk factor.2.The risk of cervical lymph node metastasis of oral squamous cell carcinoma may be promoted to a certain extent by the development of type Ⅱ diabetes,and the risk of cervical lymph node metastasis may be increased in oral squamous cell carcinoma patients with longer course of diabetes. |
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