摘要
目的:通过分析乳腺癌患者在化疗期间诱发高血糖的临床特征,了解血糖监测的重要性。方法:分析2011年1月至12月就诊于天津医科大学肿瘤医院229例非糖尿病乳腺癌患者的临床特征。化疗期间分为99例血糖浓度<7 mmol/L组和130例血糖浓度≥7 mmol/L组,按随访结束时血糖水平分为130例正常组、61例糖耐量受损(IGT)组及38例糖尿病组,165例内分泌治疗组进一步分为76例他莫昔芬(TAM)组及89例芳香化酶抑制剂(AI)组。结果:化疗期间的血糖波动水平在不同年龄、身体质量指数(BMI)、组织学分级、肿瘤特征及新辅助化疗的患者间差异均无统计学意义。截至随访结束共有15例患者死亡,正常组、IGT组及糖尿病组分别为1例(6.7%)、5例(33.3%)和9例(60.0%),三组之间差异具有统计学意义(P<0.01);患者是否接受内分泌治疗在随访结束时其血糖水平间的差异无统计学意义(P=0.79),而TAM组、AI组中血糖恢复至正常水平分别为52、40例,组间差异具有统计学意义(P=0.04)。结论:患者化疗期间的血糖水平越高,随访结束时血糖水平异常的可能性越大,且异常血糖状态会造成乳腺癌患者的不良预后,因此监测血糖意义重大。
Objective：To analyze the clinical characteristics of breast cancer patients who had hyperglycemia reactions due to che-motherapy and evaluate the significance of monitoring glucose. Methods：A total of 229 patients who had hyperglycemia during their chemotherapy sessions were included in the investigation. In particular, the participants of this study were selected based on the follow-ing criteria：those who did not have any diabetes-related diagnoses before the study period and those who had complete clinical data. At the onset of the study, the patients were divided into two groups based on the level of their blood glucose during chemotherapy （〈7 mmol/L group and ≥7 mmol/L group）. Subsequently, the patients were further divided into the following three groups based on the blood glucose level：normal, impaired glucose tolerance, and diabetes groups. The normal glucose group had 130 patients. Meanwhile, 61 and 38 patients belonged to the impaired glucose tolerance and diabetes groups, respectively. A total of 165 patients treated with hor-mone therapy were further distributed into tamoxifen （TAM）-（76 patients） and arimedex （AI）-（89 patients） treated groups. Results：No significant association was observed between the patients＇ level of blood glucose during the chemotherapy period and their clinical characteristics, including age, body mass index, histology grade, tumor characteristics, and neoadjuvant chemotherapy. A total of 15 pa-tients died during the study period. In particular, 1 （6.7%）, 5 （33.3%）, and 9 patients （60.0%） who belonged to the normal glucose, im-paired glucose tolerance, and diabetes groups, respectively, died with a significant difference of P〈0.01. We determined that hormone therapy was not significantly associated with the patients＇ succeeding blood glucose levels （P=0.79）. After further classification, 52 and 40 patients in the TAM-and AI-treated groups had normal level of blood glucose, with a significant difference of P=0.04. Conclusion：The patients＇ blood glucose level during chemotherapy influenced their glucose level in the succeeding period. Hyperglycemia may eventually predict poor prognosis. This study suggests that extensive blood glucose screening and prevention strategies among breast cancer patients may be warranted.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2015年第10期513-518,共6页
Chinese Journal of Clinical Oncology
关键词
乳腺癌
糖尿病
化疗
血糖浓度
他莫昔芬
breast cancer
diabetes
chemotherapy
blood glucose
tamoxifen
