目的 探讨血清胰岛素水平及胰岛素抵抗与子宫内膜癌发生的关系。方法 选取2011年1月至2012年1月在广西医科大学附属肿瘤医院住院的新发子宫内膜癌患者40例作为病例组,同期在我院行体检的女性48例为对照组,检测两组患者空腹血清葡萄糖(FBG)和空腹血清胰岛素(FINS)水平,计算稳态模型胰岛素抵抗指数(HOMA-IR),分析其与临床病理特征的关系。结果 病例组的FINS、HOMA-IR、雌二醇(E2)及卵泡雌激素(FSH)显著高于对照组(P均〈0.05)。FINS、HOMA-IR与不同肿瘤类型、组织学分化程度、FIGO分期、肌层浸润深度及雌、孕激素受体状态无明显相关性,差异无统计学意义(P均〉0.05)。调整可能与子宫内膜癌发生有关的危险因素后,空腹胰岛素与子宫内膜癌发生的关系不受其他因素影响。结论 FINS可能是影响子宫内膜癌发生的危险因素,其对子宫内膜癌发生危险的影响呈剂量-反应关系,胰岛素对体内性激素的影响可能是发生子宫内膜癌的机制之一。
Objective To investigate the possible association between insulin resistance and endometrial cancer. Methods Forty cases (case group) with newly diagnosed endometrial cancer and 48 healthy women(control group) from health examination at the same period were enrolled in this study.Fasting blood glucose(FBG), fasting serum insulin (FINS), estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin( PRL)were measured in all patients. Results The levels of FINS, HOMA-IR, E2 and FSH of the case group were significantly higher than those of control group (P〈O.O5).No significant correlation was observed between case group and normal control in tumor type, grade, the depth of myometrial invasion, estradiol receptor or progesterone receptor(P〉0.05).FINS related to endometrial cancer was not influenced after adjusting other confounders in this study. Conclusions FINS may be an independent risk factor in developing endometrial cancer, which has dose-response relationship,and is positively related to E2,and inversely correlated with FSH.The affect of insulin on the sex hormone might be one of the mechanisms of endometrial carelnoma.