Abstract
The relationship of type 2 diabetes mellitus (T2DM) with the prognosis of gastrointestinal (GI) tumor remains unclear. Here we studied the correlations of T2DM with GI related tumor markers and recurrence risk among 370 patients with gastric cancer and colorectal cancer underwent radical surgery in our hospital from 2011 to 2014. Recurrence was evaluated during postoperative follow-up till 2017. The differences in GI related tumor markers (CEA, CA199, CA724, CA50 and CA242) between T2DM and non-DM group were compared. The correlation of T2DM with GI tumor recurrence risk were analyzed using Cox regression analysis. Moreover, patients with T2DM were divided into subgroups according to duration (0-5 years, 6-10 years, and >10 years) and HbA1c (<6.5%, 6.5-7.49%, and ≥7.5%). Of 370 patients, 68 (18.4%) were type 2 diabetics. After a median follow-up time of 47 months, 76 cases (30.7%) had recurrence. The CEA (Ln-transformed, 1.89±1.37 vs. 1.06±1.20, P<0.001), CA199 (2.68±1.57 vs. 2.43±1.30, P=0.021) and CA724 (1.66±1.47 vs. 1.01±1.08, P=0.001) in T2DM group were remarkably higher than those in non-DM group, and no significant differences were observed in CA50 and CA242 between two groups (P>0.05); FPG was positively correlated with CEA (r=0.182, P<0.001) and CA199 (r=0.143, P=0.007). Univariate Cox regression analysis indicated that the recurrence risk was positively correlated with T2DM, age, BMI, CEA, CA199, CA724, TNM stages, lymphatic metastasis, perineural invasion (all P<0.05), which increased with the increases in T2DM duration (OR1=1.738, OR2=2.314, OR3=3.325, all P<0.05) and HbA1c (OR1=1.909, OR2=2.331, OR3=2.362, all P<0.05). Besides, multivariate analysis revealed that T2DM remained the independent risk factor of recurrence after adjusting the above confounding factors (OR=1.701, 95% CI: 0.980-2.951, P=0.039). Hence, T2DM contributes to higher levels of CEA, CA199, CA724 and increased recurrence risk of GI tumor in China. Disclosure M. Chen: None. S. Yang: None. N. Li: None. Y. Wang: None. L. Xu: None. J. Dong: None. X. Zhou: None. H. Li: None. S. Qu: None.
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