Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
Diabetes Res Clin Pract. 2018 Sep;143:239-244. doi: 10.1016/j.diabres.2018.07.018. Epub 2018 Jul 31.
To explore the association of type 2 diabetes mellitus (T2DM) with hepatocellular carcinoma (HCC) and alpha fetoprotein (AFP).
750 patients with T2DM (T2DM group), 800 healthy people (control group) and 501 patients newly diagnosed with HCC were recruited from 2010 to 2016. The HCC patients were further divided into a HCC with T2DM (HCC+DM) group and a HCC without diabetes mellitus (HCC+NDM) group.
The T2DM group had a 12.61% lower geometric mean AFP level than the healthy control group (2.08 vs. 2.38 μg/L, P < 0.001). Of 501 HCC patients, 230 (45.91%) had T2DM. When compared to the HCC+NDM group, the HCC+DM group had a higher negative rate of AFP (55.22% vs. 37.26%, P < 0.001), worse liver function (P = 0.011) and a 64.87% lower geometric mean AFP level (25.71 vs. 73.18 μg/L, P < 0.001). T2DM was significantly associated with the risk of high-grade (grade 3 and 4) HCC (OR = 2.02, 95% CI 1.18-3.44, P = 0.010).
T2DM was associated with lower AFP level, worse liver function and higher risk of high-grade HCC. We speculated that low AFP levels in diabetics might delay and interfere with HCC diagnosis, leading to higher degree of malignant HCC.
探讨 2 型糖尿病（T2DM）与肝细胞癌（HCC）和甲胎蛋白（AFP）的关系。
本研究纳入了 750 例 T2DM 患者（T2DM 组）、800 例健康对照者（对照组）和 501 例新诊断为 HCC 的患者，这些患者均于 2010 年至 2016 年期间入组。将 HCC 患者进一步分为合并 T2DM 的 HCC 患者（HCC+DM 组）和不合并糖尿病的 HCC 患者（HCC+NDM 组）。
与对照组相比，T2DM 组的 AFP 几何均数低 12.61%（2.08 vs. 2.38μg/L，P<0.001）。在 501 例 HCC 患者中，有 230 例（45.91%）合并 T2DM。与 HCC+NDM 组相比，HCC+DM 组的 AFP 阴性率更高（55.22% vs. 37.26%，P<0.001），肝功能更差（P=0.011），且 AFP 几何均数更低（25.71 vs. 73.18μg/L，P<0.001）。T2DM 与高级别（3 级和 4 级）HCC 的发病风险显著相关（OR=2.02，95%CI 1.18-3.44，P=0.010）。
T2DM 与 AFP 水平较低、肝功能较差和高级别 HCC 的风险增加相关。我们推测，糖尿病患者 AFP 水平较低可能会延迟和干扰 HCC 的诊断，导致更恶性的 HCC。
