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[既往糖尿病治疗对乳腺癌肿瘤受体表型的影响:二甲双胍与磺脲类衍生物的比较]

[Effect of previous diabetes therapy on tumor receptor phenotype in breast cancer: comparison of metformin and sulphonylurea derivatives].

作者信息

Bershteĭn L M, Boriakina M P, Turkevich E A, Tsyrlina E V, Semiglazov V F

出版信息

Vopr Onkol. 2010;56(3):312-6.

Abstract

According to some existing data, unlike sulphonylurea (SU) and insulin derivatives, treatment with biguanide metformin, for reasons still unknown, may diminish breast cancer (BC) morbidity in diabetic females. For its part, diabetes is known to worsen survival of BC patients although there is no evidence of a pathway by which antidiabetic therapy might influence the key prognostic feature of BC tissue--the tumor receptor phenotype. Combination of BC and diabetes (n=90) was studied. SU drugs were received for at least 12 months by 22 patients, biguanide metformin alone or in conjunction with SU by 15, insulin by 5, and dietary treatment alone--by 48 pts. Percentage of estrogen receptor-positive tumors did not vary significantly from group to group. However, progesterone receptor-positive (PR+) tumors in metformin-treated patients were revealed more often than in those receiving SU alone (p = 0.43) or with insulin (p = 0.041), respectively. Hence, previous treatment with metformin is expected lead to higher incidence of PR+ tumors which in turn may stimulate efficiency of hormonal therapy only in relevant group of diabetic BC patients.

摘要

根据一些现有数据,与磺脲类药物(SU)和胰岛素衍生物不同,出于尚不清楚的原因,使用双胍类二甲双胍进行治疗可能会降低糖尿病女性患乳腺癌(BC)的发病率。就糖尿病本身而言,已知其会使BC患者的生存率恶化,尽管尚无证据表明抗糖尿病治疗可能影响BC组织关键预后特征——肿瘤受体表型的途径。对BC与糖尿病合并症(n = 90)进行了研究。22例患者接受SU药物治疗至少12个月,15例单独使用双胍类二甲双胍或与SU联合使用,5例使用胰岛素,48例仅接受饮食治疗。雌激素受体阳性肿瘤的百分比在各组之间无显著差异。然而,二甲双胍治疗患者中孕激素受体阳性(PR+)肿瘤的发现频率分别高于单独接受SU治疗(p = 0.43)或与胰岛素联合治疗(p = 0.041)的患者。因此,预期先前使用二甲双胍治疗会导致PR+肿瘤的发生率更高,这反过来可能仅在相关的糖尿病BC患者组中提高激素治疗的疗效。

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