Lu Mengmeng, Zhou Jinhua, Wang Lei, Miao Jianlong, Liu Ruijuan
Jining Medical College, Jining, Shandong, PR China.
Department of Pulmonary and Critical Care Medicine, Jining No. 1 People's Hospital, Jining, Shandong, PR China.
Medicine (Baltimore). 2025 Jul 4;104(27):e43054. doi: 10.1097/MD.0000000000043054.
This study examined factors influencing lung cancer in patients with type 2 diabetes mellitus (T2DM). A total of 111 patients with T2DM diagnosed with stage IIIB or IV lung cancer and treated at Jining No. 1 People's Hospital between January 2015 and December 2020 were included. Diagnoses were confirmed through bronchoscopy and/or percutaneous biopsy under computed tomography guidance. Patient age, sex, pathological type, treatment, and progression-free survival (PFS) were recorded. Survival analysis and Cox proportional hazards model multifactor analysis were performed using the Kaplan-Meier method to identify factors influencing survival. Univariate analysis revealed the following: (1) PFS was significantly longer in women than in men (12.50 vs 8.63 months, relative risk [RR] = 0.76, 95% confidence interval [CI] = 0.45-1.28, P = .042), (2) PFS differed significantly among patients with adenocarcinoma, squamous cell carcinoma, and small cell lung cancer (12.29 vs 10.02 vs 7.12 months, RR = 1.5, 95% CI = 1.07-2.0, P = .027). Compared with small cell lung cancer, PFS was significantly longer in adenocarcinoma (12.29 vs 7.12 months, P = .011), (3) PFS varied across chemotherapy, tyrosine kinase inhibitor therapy, and chemoradiotherapy (6.69 vs 14.50 vs 13.97 months, RR = 0.86, 95% CI = 0.74-0.99, P = .001). Compared with chemotherapy, PFS was significantly longer in patients receiving targeted therapy and chemoradiotherapy (14.50 vs 6.69 months, P = .001; 13.97 vs 6.69 months, P = .008), and (4) No significant difference in PFS was observed between patients who received metformin therapy and those who did not (9.96 vs 9.95 months, P = .926). In multivariate analysis, pathological type and treatment modality were identified as independent factors influencing PFS in patients with advanced lung cancer and T2DM (P < .05). In patients with advanced lung cancer and T2DM, PFS was significantly longer in women, particularly those with adenocarcinoma and those treated with epidermal growth factor receptor-tyrosine kinase inhibitors or chemoradiotherapy. Pathological type and treatment were independent factors influencing PFS in these patients.
本研究探讨了影响2型糖尿病（T2DM）患者肺癌发病的因素。纳入了2015年1月至2020年12月期间在济宁市第一人民医院接受治疗、诊断为ⅢB期或Ⅳ期肺癌的111例T2DM患者。诊断通过支气管镜检查和/或计算机断层扫描引导下的经皮活检得以证实。记录患者的年龄、性别、病理类型、治疗情况及无进展生存期（PFS）。采用Kaplan-Meier法进行生存分析和Cox比例风险模型多因素分析，以确定影响生存的因素。单因素分析结果如下：（1）女性的PFS显著长于男性（12.50个月对8.63个月，相对风险[RR]=0.76，95%置信区间[CI]=0.45 - 1.28，P=0.042）；（2）腺癌、鳞状细胞癌和小细胞肺癌患者的PFS差异显著（12.29个月对10.02个月对7.12个月，RR=1.5，95%CI=1.07 - 2.0，P=0.027）。与小细胞肺癌相比，腺癌患者的PFS显著更长（12.29个月对7.12个月，P=0.011）；（3）化疗、酪氨酸激酶抑制剂治疗和放化疗患者的PFS各不相同（6.69个月对14.50个月对13.97个月，RR=0.86，95%CI=0.74 - 0.99，P=0.001）。与化疗相比，接受靶向治疗和放化疗患者的PFS显著更长（14.50个月对6.69个月，P=0.001；13.97个月对6.69个月，P=0.008）；（4）接受二甲双胍治疗的患者与未接受该治疗的患者在PFS方面未观察到显著差异（9.96个月对9.95个月，P=0.926）。多因素分析中，病理类型和治疗方式被确定为影响晚期肺癌合并T2DM患者PFS的独立因素（P<0.05）。在晚期肺癌合并T2DM患者中，女性的PFS显著更长，尤其是腺癌女性患者以及接受表皮生长因子受体 - 酪氨酸激酶抑制剂或放化疗的患者。病理类型和治疗是影响这些患者PFS的独立因素。
