摘要
目的:探索空腹胰岛素水平与肿瘤复发转移之间的关联性。方法:横断面收集2021年5—10月苏州市中医医院的非糖尿病肿瘤患者153例的资料及2022年1—12月苏州大学附属第一医院、昆山市中医医院、盐城市第二人民医院的非糖尿病肝癌、胰腺癌、乳腺癌和肺癌患者共137例的资料。计量资料采用Unpaired t或Mann-Whitney非参数检验;计数资料采用χ^(2)或Fisher确切概率法检验;相关性采用Spearman相关分析法。结果:153例肿瘤患者中空腹胰岛素水平在正常范围有125例(81.7%),其中在>5.0~10.0μU/mL等级内的肿瘤复发转移率最低;以>5.0~10.0μU/mL等级为基础,随着空腹胰岛素水平等级的升高或降低,复发转移率均逐渐增高(均P<0.05),两者之间分别呈正相关(r=0.290,P=0.004)和负向弱相关趋势(r=-0.189, P=0.061)。术后肿瘤患者空腹胰岛素水平等级的增高或降低,复发转移率均增加(均P<0.05);而在非手术肿瘤患者中差异无统计学意义(P>0.05)。肝癌复发转移组的空腹胰岛素处于等级偏高水平,平均值明显高于非复发转移组(P<0.05);胰腺癌患者的空腹胰岛素处于低等级水平,复发转移组平均值低于非复发转移组,但差异无统计学意义(P>0.05);乳腺癌复发转移组的空腹胰岛素水平呈二头分散的分布趋势,平均值高于非复发转移组(P<0.05);肺癌复发转移组的平均空腹胰岛素水平与非复发转移组差异无统计学意义(P>0.05)。结论:空腹胰岛素水平在临床正常范围内的增高或降低,可能是肿瘤患者复发转移的风险因子之一,尤其对肝癌、胰腺癌和乳腺癌等肿瘤的术后复发转移的风险预测和治疗靶标更有意义。
Objective:To explore the association between fasting insulin level and tumor recurrence and metastasis.Methods:153 tumor patients without diabetes in Suzhou Hospital of Traditional Chinese Medicine were collected from May to October 2021 by a cross-sectionsal study.137 non-diabetic cancer patients including pancreatic,hepatocellular,breast and lung cancer in the First Hospital of Soochow University,Kunshan Hospital of Traditional Chinese Medicine and Yancheng Second People′s Hospital were collected from January to December 2022 by a cross-sectional study.Unpaired t test or Mann-Whitney nonparametric test was used for measurement data,andχ^(2) or Fisher′s exact test was used for count data,and Spearman′s correlation analysis was used for correlation.Results:125(81.7%)of 153 tumor patients presents normal range fasting insulin levels,and the tumor recurrence and metastasis rate was the lowest in the grade of>5.0-10.0μU/mL.Compared with the grade of>5.0-10.0μU/mL,an increase or decrease in fasting insulin level grade,the recurrence and metastasis rate gradually increased(P<0.05),and there was a positive weak correlation(r=0.290,P=0.004)and a negative weak correlation(r=-0.189,P=0.061)between them,respectively.While there was no significant difference in non-operative tumor patients(P>0.05),the rate of recurrent metastasis was increased by either increasing or decreasing fasting insulin level grade in postoperative tumor patients(P<0.05).The fasting insulin level in patients with recurrent metastasis of liver cancer was at a high grade level,and the mean value was significantly higher than that in the non-recurrent metastasis group(P<0.05).The fasting insulin level in patients with pancreatic cancer was at a low grade level,and the mean value in the recurrent metastasis group was lower than that in the non-recurrent metastasis group(P<0.05).The fasting insulin level in patients with recurrent metastasis of breast cancer showed a dichotomous distribution trend,and the mean value was higher than that in the non-recurrent metastasis group(P<0.05).The fasting insulin level in recurrent metastases of lung cancer was no significant difference that in non-recurrent metastases group(P>0.05).Conclusion:The increase or decrease of fasting insulin level within the clinical normal range may be one of the risk factors for recurrent metastasis in tumor patients,especially for the risk prediction and therapeutic targeting of postoperative recurrent metastasis in liver cancer,pancreatic cancer and breast cancer.
作者
刘敏
张露蓉
王璐
杨文娟
徐彩华
宋秀道
周婷婷
孙华
欧阳怡然
蒋健鸿
宋卿
陈心恬
袁琴
江国荣
LIU Min;ZHANG Lurong;WANG Lu;YANG Wenjuan;XU Caihua;SONG Xiudao;ZHOU Tingting;SUN Hua;OUYANG Yiran;JIANG Jianhong;SONG Qing;CHEN Xintian;YUAN Qin;JIANG Guorong(Department of Oncology,Suzhou Hospital of Traditional Chinese Medicine,Jiangsu Province,Suzhou 215009;Suzhou Academy of Wumen Chinese Medicine,Suzhou Hospital of Traditional Chinese Medicine,Jiangsu Province,Suzhou 215009;Department of Oncology,Yancheng Second People′s Hospital,Jiangsu Province;Department of Oncology,Kunshan Hospital of Traditional Chinese Medicine,Jiangsu Province;Department of Oncology,the First Affiliated Hospital of Soochow University)
出处
《南通大学学报（医学版）》
2023年第6期513-517,共5页
Journal of Nantong University(Medical sciences)
基金
国家自然科学基金资助项目(82274423,81973740)
苏州市姑苏卫生人才科研项目(GSWS2022078)。
关键词
空腹胰岛素
肿瘤复发转移
相关性
肝癌
胰腺癌
乳腺癌
fasting insulin
tumor recurrence and metastasis
correlation
liver cancer
pancreatic cancer
breast cancer
