Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gynecol Oncol. 2010 Mar;116(3):459-63. doi: 10.1016/j.ygyno.2009.11.016. Epub 2009 Dec 8.
The aim of this study was to evaluate the association between pretreatment random plasma glucose levels and cancer prognosis in non-diabetic women with locally advanced cervical cancer treated with CCRT (concurrent chemoradiation) or RT (radiation therapy) only.
We investigated the non-fasting plasma glucose levels checked during the initial work up before treatment in 134 non-diabetic patients with locally advanced cervical cancer. Based on the survival time and the progression-free interval (PFI) recorded in the electronic medical records Cox proportional hazard regression models were used to estimate the hazard ratio (HR) for overall survival and PFI according to the various level of glucose and a cut-off level (<102 mg/dL and >or=102 mg/dL), adjusting for clinical covariates.
A shorter overall survival and PFI was observed in the group with higher glucose levels (HR, 1.03; p=0.002, HR, 1.02; p=0.001, respectively) and more than 102 mg/dL, by univariate analyses (HR, 3.21; p=0.012, HR, 2.20; p=0.006, respectively). Multivariate analysis, adjusting for clinical FIGO stage, performance status, treatment type (CCRT vs. RT) and chemotherapeutic regimen types showed that patients with higher glucose levels or more than >or=102 mg/dL had shorter overall survival times (HR, 1.02; p=0.015, HR, 2.54; p=0.049, respectively) and PFI (HR, 1.02; p=0.003, HR, 1.88; p=0.031, respectively).
This investigation provides evidence supporting the prognostic value of glucose levels in non-diabetic women with locally advanced cervical cancer treated with radiation therapy and/or concurrent chemotherapy; high glucose levels were associated with a greater risk for recurrence and mortality in these patients.
本研究旨在评估非糖尿病局部晚期宫颈癌患者在接受 CCRT（同期放化疗）或仅接受 RT（放疗）治疗前的随机血浆葡萄糖水平与癌症预后之间的关系。
我们研究了 134 例局部晚期宫颈癌未接受治疗的非糖尿病患者初始检查时的非空腹血浆葡萄糖水平。根据电子病历中记录的生存时间和无进展间隔（PFI），使用 Cox 比例风险回归模型，根据葡萄糖的不同水平（<102mg/dL 和≥102mg/dL）和截断值（<102mg/dL 和≥102mg/dL），对总体生存率和 PFI 进行估计，调整临床协变量。
单因素分析显示，高血糖组（HR，1.03；p=0.002，HR，1.02；p=0.001）和血糖水平>102mg/dL 组的总生存时间和 PFI 较短。多因素分析，调整临床 FIGO 分期、体能状态、治疗方式（CCRT 与 RT）和化疗方案类型后，显示高血糖或血糖水平>or=102mg/dL 的患者总生存时间较短（HR，1.02；p=0.015，HR，2.54；p=0.049）和 PFI（HR，1.02；p=0.003，HR，1.88；p=0.031）。
本研究为接受放疗和/或同期化疗的局部晚期宫颈癌非糖尿病女性的血糖水平提供了预后价值的证据；高血糖水平与这些患者的复发和死亡风险增加相关。
