Clinical analysis of the short-term prognosis after resection surgery in patients with non-small cell lung cancer combined with type 2 diabetes_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Wei , FENG Tianci ,  WANG Xiaowen ,  HUANG Chun , XIANG Xiaoyong , WU Qingchen

Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R.China;

Corresponding?author：

WANG Xiaowen, Email: xiaowenwang@yeah.net; HUANG Chun, Email: hcsurgery@163.com

Keywords：

Type 2 diabetes mellitus; lung cancer; complications; prognosis; surgery

DOI：

10.7507/1007-4848.202001045

Video：

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Objective To analyze the effect of type 2 diabetes (T2DM) on the short-term prognosis of patients with non-small cell lung cancer (NSCLC) after resection surgery.Methods Clinical data of 207 NSCLC patients who underwent resection surgery in our hospital from January 2016 to January 2019 were retrospectively analyzed. The 100 NSCLC patients with T2DM were allocated to a T2DM group (58 males and 42 females, with an average age of 65.26±7.26 years), and 107 patients without T2DM were allocated to a non-T2DM group (66 males and 41 females, with an average age of 64.21±7.51 years). The short-term prognosis of the patients was compared between the two groups.Results Compared with the non-T2DM group, the postoperative atelectasis (P=0.012) and pulmonary infection (P=0.040) were statistically different in the T2DM group. The postoperative complication rate in the T2DM group was significantly higher than that in the non-T2DM group (66.0% vs. 33.6%, P<0.001). The postoperative hospitalization time in the T2DM group was longer than that in the non-T2DM group (9.83±6.35 d vs. 8.09±4.40 d, P=0.007).Conclusion T2DM will increase the incidence of postoperative complications, prolong the length of hospital stay and increase the economic burden of the NSCLC patients, which is not conducive to the postoperative prognosis of patients.

Citation： CHEN Wei, FENG Tianci, WANG Xiaowen, HUANG Chun, XIANG Xiaoyong, WU Qingchen. Clinical analysis of the short-term prognosis after resection surgery in patients with non-small cell lung cancer combined with type 2 diabetes. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(8): 912-917. doi: 10.7507/1007-4848.202001045 Copy

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2.	程小龍, 韓一平. 糖尿病對肺癌的影響及其生物學機制. 中國全科醫學, 2018, 21(15): 1779-1784.
3.	Luo J, Hendryx M, Qi L, et al. Pre-existing diabetes and lung cancer prognosis. Br J Cancer, 2016, 115(1): 76-79.
4.	Zhu L, Cao H, Zhang T, et al. The effect of diabetes mellitus on lung cancer prognosis: A PRISMA-compliant meta-analysis of cohort studies. Medicine (Baltimore), 2016, 95(17): e3528.
5.	Zhang J, Zhao T, Long S, et al. Risk factors for postoperative infection in Chinese lung cancer patients: A meta-analysis. J Evid Based Med, 2017, 10(4): 255-262.
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7.	何洪波, 祝之明. 我國糖尿病合并高血壓的流行病學和治療現狀. 中國科學 (生命科學), 2018, 48(8): 855-865.
8.	Tatsumi Y, Ohkubo T. Hypertension with diabetes mellitus: significance from an epidemiological perspective for Japanese. Hypertens Res, 2017, 40(9): 795-806.
9.	陳軍. 肺癌術后圍手術期心肺并發癥相關因素的研究. 河北醫科大學, 2014.
10.	高寶. 老年患者肺手術后肺部并發癥相關危險因素分析. 吉林大學, 2016.
11.	Pei G, Zhou S, Han Y, et al. Risk factors for postoperative complications after lung resection for non-small cell lung cancer in elderly patients at a single institution in China. J Thorac Dis, 2014, 6(9): 1230-1238.
12.	Kim ES, Kim YT, Kang CH, et al. Prevalence of and risk factors for postoperative pulmonary complications after lung cancer surgery in patients with early-stage COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11: 1317-1326.
13.	萬林, 樊媛, 黨曉燕, 等. 肺癌患者術后呼吸功能衰竭的相關因素分析. 臨床醫學研究與實踐, 2019, 4(19): 118-119.
14.	張化芝, 郭曉燁, 李曉雙, 等. 肺癌術后并發肺部感染的病原學分析及影響因素分析. 中華醫院感染學雜志, 2018, 28(1): 77-80.
15.	Li Y, Ma YL, Gao YY, et al. Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery. J Thorac Dis, 2017, 9(6): 1565-1573.
16.	劉江濤. 2 型糖尿病對非小細胞肺癌患者術后肺部感染及預后的影響. 新疆醫科大學, 2012.
17.	Klekotka RB, Mizga?a E, Król W. The etiology of lower respiratory tract infections in people with diabetes. Pneumonol Alergol Pol, 2015, 83(5): 401-408.
18.	Huang CH, Tsai JS, Chen IW, et al. Risk factors for in-hospital mortality in patients with type 2 diabetes complicated by community-acquired Klebsiella pneumoniae bacteremia. J Formos Med Assoc, 2015, 114(10): 916-922.
19.	于露, 梁良. 高血糖對肺癌患者肺功能的影響. 現代醫藥衛生, 2018, 34(11): 1699-1700.
20.	Jagadapillai R, Rane MJ, Lin X, et al. Diabetic microvascular disease and pulmonary fibrosis: The contribution of platelets and systemic inflammation. Int J Mol Sci, 2016, 17(11): 1853.
21.	Wang R, Sheng M, Shi F, et al. Dysfunctional phagocytosis capacity, granulocyte recruitment and inflammatory factor secretion of Kupffer cells in diabetes mellitus reversed by Lidocaine. Diabetes Metab Syndr Obes, 2018, 11: 827-834.
22.	Lee CH, Chen IL, Chuah SK, et al. Impact of glycemic control on capsular polysaccharide biosynthesis and opsonophagocytosis of Klebsiella pneumoniae: Implications for invasive syndrome in patients with diabetes mellitus. Virulence, 2016, 7(7): 770-778.
23.	朱東, 魯麗利, 張劍豐, 等. 糖尿病患者免疫功能改變與預防肺部感染的臨床研究. 中華醫院感染學雜志, 2015, 25(8): 1790-1792.
24.	Yende S, van der Poll T, Lee M, et al. The influence of pre-existing diabetes mellitus on the host immune response and outcome of pneumonia: analysis of two multicentre cohort studies. Thorax, 2010, 65(10): 870-877.
25.	蔡巍維, 徐穎. 圍術期肺不張的形成機制及其危險因素研究進展. 臨床醫學研究與實踐, 2019, 4(12): 196-198.
26.	Hedenstierna G, Edmark L. Mechanisms of atelectasis in the perioperative period. Best Pract Res Clin Anaesthesiol, 2010, 24(2): 157-169.
27.	Foster DJ, Ravikumar P, Bellotto DJ, et al. Fatty diabetic lung: altered alveolar structure and surfactant protein expression. Am J Physiol Lung Cell Mol Physiol, 2010, 298(3): L392-L403.
28.	Kopf S, Groener JB, Kender Z, et al. Breathlessness and restrictive lung disease: an important diabetes-related feature in patients with type 2 diabetes. Respiration, 2018, 96(1): 29-40.
29.	Yang J, Xue Q, Miao L, et al. Pulmonary fibrosis: a possible diabetic complication. Diabetes Metab Res Rev, 2011, 27(4): 311-317.
30.	鮑哲, 陳春青, 柯賽賽, 等. 糖尿病合并肺部感染危險因素分析及預防. 中華醫院感染學雜志, 2013, 23(6): 1295-1297.

1. Hemminki K, Li X, Sundquist J, et al. Risk of cancer following hospitalization for type 2 diabetes. Oncologist, 2010, 15(6): 548-555.
2. 程小龍, 韓一平. 糖尿病對肺癌的影響及其生物學機制. 中國全科醫學, 2018, 21(15): 1779-1784.
3. Luo J, Hendryx M, Qi L, et al. Pre-existing diabetes and lung cancer prognosis. Br J Cancer, 2016, 115(1): 76-79.
4. Zhu L, Cao H, Zhang T, et al. The effect of diabetes mellitus on lung cancer prognosis: A PRISMA-compliant meta-analysis of cohort studies. Medicine (Baltimore), 2016, 95(17): e3528.
5. Zhang J, Zhao T, Long S, et al. Risk factors for postoperative infection in Chinese lung cancer patients: A meta-analysis. J Evid Based Med, 2017, 10(4): 255-262.
6. 肖政, 劉蓮花, 汪成瓊, 等. 我國肺癌患者醫院感染高危因素 Meta 分析. 中國感染控制雜志, 2016, 15(8): 561-569.
7. 何洪波, 祝之明. 我國糖尿病合并高血壓的流行病學和治療現狀. 中國科學 (生命科學), 2018, 48(8): 855-865.
8. Tatsumi Y, Ohkubo T. Hypertension with diabetes mellitus: significance from an epidemiological perspective for Japanese. Hypertens Res, 2017, 40(9): 795-806.
9. 陳軍. 肺癌術后圍手術期心肺并發癥相關因素的研究. 河北醫科大學, 2014.
10. 高寶. 老年患者肺手術后肺部并發癥相關危險因素分析. 吉林大學, 2016.
11. Pei G, Zhou S, Han Y, et al. Risk factors for postoperative complications after lung resection for non-small cell lung cancer in elderly patients at a single institution in China. J Thorac Dis, 2014, 6(9): 1230-1238.
12. Kim ES, Kim YT, Kang CH, et al. Prevalence of and risk factors for postoperative pulmonary complications after lung cancer surgery in patients with early-stage COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11: 1317-1326.
13. 萬林, 樊媛, 黨曉燕, 等. 肺癌患者術后呼吸功能衰竭的相關因素分析. 臨床醫學研究與實踐, 2019, 4(19): 118-119.
14. 張化芝, 郭曉燁, 李曉雙, 等. 肺癌術后并發肺部感染的病原學分析及影響因素分析. 中華醫院感染學雜志, 2018, 28(1): 77-80.
15. Li Y, Ma YL, Gao YY, et al. Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery. J Thorac Dis, 2017, 9(6): 1565-1573.
16. 劉江濤. 2 型糖尿病對非小細胞肺癌患者術后肺部感染及預后的影響. 新疆醫科大學, 2012.
17. Klekotka RB, Mizga?a E, Król W. The etiology of lower respiratory tract infections in people with diabetes. Pneumonol Alergol Pol, 2015, 83(5): 401-408.
18. Huang CH, Tsai JS, Chen IW, et al. Risk factors for in-hospital mortality in patients with type 2 diabetes complicated by community-acquired Klebsiella pneumoniae bacteremia. J Formos Med Assoc, 2015, 114(10): 916-922.
19. 于露, 梁良. 高血糖對肺癌患者肺功能的影響. 現代醫藥衛生, 2018, 34(11): 1699-1700.
20. Jagadapillai R, Rane MJ, Lin X, et al. Diabetic microvascular disease and pulmonary fibrosis: The contribution of platelets and systemic inflammation. Int J Mol Sci, 2016, 17(11): 1853.
21. Wang R, Sheng M, Shi F, et al. Dysfunctional phagocytosis capacity, granulocyte recruitment and inflammatory factor secretion of Kupffer cells in diabetes mellitus reversed by Lidocaine. Diabetes Metab Syndr Obes, 2018, 11: 827-834.
22. Lee CH, Chen IL, Chuah SK, et al. Impact of glycemic control on capsular polysaccharide biosynthesis and opsonophagocytosis of Klebsiella pneumoniae: Implications for invasive syndrome in patients with diabetes mellitus. Virulence, 2016, 7(7): 770-778.
23. 朱東, 魯麗利, 張劍豐, 等. 糖尿病患者免疫功能改變與預防肺部感染的臨床研究. 中華醫院感染學雜志, 2015, 25(8): 1790-1792.
24. Yende S, van der Poll T, Lee M, et al. The influence of pre-existing diabetes mellitus on the host immune response and outcome of pneumonia: analysis of two multicentre cohort studies. Thorax, 2010, 65(10): 870-877.
25. 蔡巍維, 徐穎. 圍術期肺不張的形成機制及其危險因素研究進展. 臨床醫學研究與實踐, 2019, 4(12): 196-198.
26. Hedenstierna G, Edmark L. Mechanisms of atelectasis in the perioperative period. Best Pract Res Clin Anaesthesiol, 2010, 24(2): 157-169.
27. Foster DJ, Ravikumar P, Bellotto DJ, et al. Fatty diabetic lung: altered alveolar structure and surfactant protein expression. Am J Physiol Lung Cell Mol Physiol, 2010, 298(3): L392-L403.
28. Kopf S, Groener JB, Kender Z, et al. Breathlessness and restrictive lung disease: an important diabetes-related feature in patients with type 2 diabetes. Respiration, 2018, 96(1): 29-40.
29. Yang J, Xue Q, Miao L, et al. Pulmonary fibrosis: a possible diabetic complication. Diabetes Metab Res Rev, 2011, 27(4): 311-317.
30. 鮑哲, 陳春青, 柯賽賽, 等. 糖尿病合并肺部感染危險因素分析及預防. 中華醫院感染學雜志, 2013, 23(6): 1295-1297.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of the short-term prognosis after resection surgery in patients with non-small cell lung cancer combined with type 2 diabetes

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