背景与目的:在十九世纪早期,人们即认识到胰腺癌与糖尿病(DM)的关系,但至今两者的因果关系仍有争论,本文探讨两者的关联,从而提高胰腺癌早期诊断水平。方法:对2003年12月-2005年2月收住我院的胰腺癌合并DM患者及非合并DM患者共83例进行回顾性分析,并将其中13例以DM为首发症状或DM病情加重胰腺癌患者与另外20例病程匹配的2型糖尿病(T2DM)进行年龄、体重指数、DM家族史及实验室指标的比较。结果:①83例胰腺癌中,35例(42.17%)合并DM,其中24(68.57%)例DM病程小于2年(其中14(40%)例与胰腺癌同时发现),8(22.86%)例DM病程大于2年,3例DM病程不详。胰腺癌合并DM患者高血压的患病率高于非DM患者(45.71%vs25%,P<0.05)。②胰腺癌合并DM患者腹痛(χ2=5.332,P<0.01)、纳差(χ2=3.867,P<0.01)的发生率低于非DM患者。③胰腺癌合并DM患者直接胆红素(DB)(χ2=23.46,P<0.01)升高发生率较低。④两组患者在肿瘤的部位、转移、手术情况和生存期差异无统计学意义。⑤13例以DM为首发症状或DM病情加重胰腺癌患者与20例T2DM进行比较,胰腺癌患者发病年龄较大(68.93±10.62vs55.6±11.14岁,P<0.01)且体型更消瘦(BMI21.51±1.98vs23.87±3.04kg/m2,P<0.01)。结论:胰腺癌为进展较快的肿瘤,即使合并DM,也不影响胰腺癌临床表现及预后。对于高龄且消瘦初发DM患者及血糖短期恶化DM患者,要警惕胰腺癌的发生。 BACKGROUND & OBJECTIVE: In the early nineteenth century, people recognized the relationship between pancreatic cancer and diabetes mellitus (DM), but so far the causal relationship between the two is still controversial. This article explores the relationship between the two so as to improve the early diagnosis of pancreatic cancer. Methods: A total of 83 patients with DM and non-DM DM admitted to our hospital from December 2003 to February 2005 were retrospectively analyzed. Among them, 13 patients with DM as the first symptom or DM exacerbated the pancreas Cancer patients and another 20 patients with type 2 diabetes (T2DM) were matched for age, body mass index, family history of DM, and laboratory parameters. Results: ①83 cases of pancreatic cancer, 35 cases (42.17%) with DM, of which 24 (68.57%) cases of DM duration of less than 2 years (of which 14 (40%) were found with pancreatic cancer), 8 DM duration of more than 2 years, 3 cases of DM duration unknown. The prevalence of hypertension in DM patients with pancreatic cancer was higher than that in non-DM patients (45.71% vs 25%, P <0.05). ② The incidence of abdominal pain (χ2 = 5.332, P <0.01) in patients with DM combined with DM was significantly lower than that in non-DM patients (χ2 = 3.867, P <0.01). ③ The incidence of elevated direct bilirubin (DB) (χ2 = 23.46, P <0.01) was lower in DM patients with DM. The two groups of patients in the tumor site, metastasis, surgical status and survival was no significant difference. ⑤There were 13 cases with DM as the first symptom or DM with exacerbation of pancreatic cancer compared with 20 cases with T2DM. The age of onset of pancreatic cancer was higher (68.93 ± 10.62 vs 55.6 ± 11.14 years, P <0.01) and the body weight was more emaciated (BMI21. 51 ± 1.98 vs 23.87 ± 3.04 kg / m2, P <0.01). Conclusion: Pancreatic cancer is a rapidly progressing tumor. Even with DM, it does not affect the clinical manifestations and prognosis of pancreatic cancer. For elderly and wasting newly diagnosed DM patients and DM patients with short-term worsening of blood glucose, we must guard against the occurrence of pancreatic cancer.