【摘要】  目的   分析T2DM合并恶性肿瘤的临床特点，为其防治提供参考。  方法    回顾性调查T2DM合并恶性肿瘤患者880例，根据性别、年龄、分期、肿瘤发生先后和两种疾病的用药情况等不同特点进行分类比较。 结果   (1)T2DM合并恶性肿瘤男女分别占58.64％(516/880)、41.36％(364/880)，各年龄段男女构成比差异无统计学意义。高发年龄在50～80岁。(2)肿瘤好发部位依次为消化系统(50.23％)、呼吸系统(12.72％)、血液系统(11.48％)、泌尿系统(6.02％)和妇科肿瘤(5.80％)，排名前4位系统中男女构成比比较差异有统计学意义，且男性居多。具体部位排序为结直肠癌(17.16％)、肺癌(12.70％)、肝(11.71％)、胃癌(10.91％)、乳腺癌(7.61％)和胰腺癌(6.36％)。(3)恶性肿瘤多在中晚期(Ⅲ、IV期占70.89％)。(4)T2DM继发肿瘤相比肿瘤继发T2DM时间间隔长，差异有统计学意义。(5)抗T2DM药物使用频率依次是磺脲类(28.28％)、胰岛素(25.04％)和二甲双胍(22.49％)。乳腺癌(28.77％)gl血液系统肿瘤(38.36％)化疗后较易出现血糖升高。铂类、蒽环类、嘧啶类、紫杉类、糖皮质激素和环磷酰胺类化疗药物易引起血糖升高。 结论   T2DM合并恶性肿瘤以中老年男性居多，发现时多在中晚期。T2DM继发肿瘤相比肿瘤继发T2DM时阀间隔长。T2DM治疗需重视二甲双胍的“基石”地位。恶性肿瘤治疗过程有血糖升高的

风险。
     【关键词】 糖尿病，2型；恶性肿瘤；治疗

     【Abstraet】  Objective  To investigate the clinical features of T2DM with malignant tumor，and provide information for prevention and treatment of T2DM with malignant tumors． Methods   A total 0f 880 T2DM patients with malignant tumor were enrolled in this study by retrospective survey method.Comparison was carried out according to their gender，age，tumor staging，tumor occurrence time and treatment for goth diseases． Results   (1)The percentage of men and women in diabetic patients with malignant tumor were 58.64％ (516/880) and 41.36％ (364/880) respectively．The differences of sex proportion in all ages were not statistically significant. Tumor incidence age was between 50~80 years
old. (2)Tumor sites order：the digestive system(50.23％)，respiratory system(12.72％)，blood system(11.48％)，urinary tract tumors(6．02％)and gynecological tumors(5．80％)；The percentage of men was significantly higher than women in the first four systems．The top six tumors was：colorectal cancer (17.16％)，lung cancer(12．70％)，hepatic cancer(11.71％)，gastric cancer (10.91％)，breast cancer (7.61％)and pancreatic cancer(6.36％)．(3)Most malignant tumors were in the middle-late period(Ⅲ，Ⅳaccounted for 70.89％)．(4)Time interval of diabetes with secondary tumors is significantly longer than tumor with secondary diabetes．(5)Anti—diabetic drug use frequency order was as follows：sulfonylureas (28.28％)，insulin (25.04％)and metforrnin (22.49％)．Elevated blood sugar appeared more in patients
with breast cancer(28.77％)and blood system tumor(38.36％)after chemotherapy．Platinum，anthracycline-based，pyrimidine，purple ball，glucocorticoid and cyclophosphamide were more easily to cause hyperglycemia.  Conclusion   In T2DM with malignant tumor，the middle-aged males comprised amajor part，and always in the middle-late stages．Time interval of diabetes with secondary tumors is significantly longer than tumor with secondary diabetes．Metformin is the footstone antidiabetic drug，and more attention should be paid to it during the treatment of T2DM．The risk of hyperglycemia increasedduring the treatment of malignant tumor．
    【Key words】Diabetes mellitus，type 2；Malignant tumor；Treatment