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.	程小龙, 韩一平. 糖尿病对肺癌的影响及其生物学机制. 中国全科医学, 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, 刘莲花, 汪成琼, 等. 我国肺癌患者医院感染高危因素 Meta 分析. 中国感染控制杂志, 2016, 15(8): 561-569.
7.	何洪波, 祝之明. 我国糖尿病合并高血压的流行病学和治疗现状. 中国科学 (生命科学), 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.	陈军. 肺癌术后围手术期心肺并发症相关因素的研究. 河北医科大学, 2014.
10.	高宝. 老年患者肺手术后肺部并发症相关危险因素分析. 吉林大学, 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.	万林, 樊媛, 党晓燕, 等. 肺癌患者术后呼吸功能衰竭的相关因素分析. 临床医学研究与实践, 2019, 4(19): 118-119.
14.	张化芝, 郭晓烨, 李晓双, 等. 肺癌术后并发肺部感染的病原学分析及影响因素分析. 中华医院感染学杂志, 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.	刘江涛. 2 型糖尿病对非小细胞肺癌患者术后肺部感染及预后的影响. 新疆医科大学, 2012.
17.	Klekotka RB, Mizgała 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. 高血糖对肺癌患者肺功能的影响. 现代医药卫生, 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.	朱东, 鲁丽利, 张剑丰, 等. 糖尿病患者免疫功能改变与预防肺部感染的临床研究. 中华医院感染学杂志, 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.	蔡巍维, 徐颖. 围术期肺不张的形成机制及其危险因素研究进展. 临床医学研究与实践, 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.	鲍哲, 陈春青, 柯赛赛, 等. 糖尿病合并肺部感染危险因素分析及预防. 中华医院感染学杂志, 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. 程小龙, 韩一平. 糖尿病对肺癌的影响及其生物学机制. 中国全科医学, 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, 刘莲花, 汪成琼, 等. 我国肺癌患者医院感染高危因素 Meta 分析. 中国感染控制杂志, 2016, 15(8): 561-569.
7. 何洪波, 祝之明. 我国糖尿病合并高血压的流行病学和治疗现状. 中国科学 (生命科学), 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. 陈军. 肺癌术后围手术期心肺并发症相关因素的研究. 河北医科大学, 2014.
10. 高宝. 老年患者肺手术后肺部并发症相关危险因素分析. 吉林大学, 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. 万林, 樊媛, 党晓燕, 等. 肺癌患者术后呼吸功能衰竭的相关因素分析. 临床医学研究与实践, 2019, 4(19): 118-119.
14. 张化芝, 郭晓烨, 李晓双, 等. 肺癌术后并发肺部感染的病原学分析及影响因素分析. 中华医院感染学杂志, 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. 刘江涛. 2 型糖尿病对非小细胞肺癌患者术后肺部感染及预后的影响. 新疆医科大学, 2012.
17. Klekotka RB, Mizgała 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. 高血糖对肺癌患者肺功能的影响. 现代医药卫生, 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. 朱东, 鲁丽利, 张剑丰, 等. 糖尿病患者免疫功能改变与预防肺部感染的临床研究. 中华医院感染学杂志, 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. 蔡巍维, 徐颖. 围术期肺不张的形成机制及其危险因素研究进展. 临床医学研究与实践, 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. 鲍哲, 陈春青, 柯赛赛, 等. 糖尿病合并肺部感染危险因素分析及预防. 中华医院感染学杂志, 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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