Zhang Z-J, Li S
Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China.
Diabetes Obes Metab. 2014 Aug;16(8):707-10. doi: 10.1111/dom.12267. Epub 2014 Feb 27.
Emerging evidence from epidemiologic studies and basic science suggests a potential antitumour effect of metformin. However, whether metformin improves survival in cancer patients remains inconclusive.
A literature search was performed using the PubMed, EMbase and SciVerse Scopus databases. Pooled effect estimates were derived using a random-effects meta-analysis model.
Of the 28 studies retrieved, the pooled effect estimates showed that metformin was associated with lower risk of all-cause mortality in cancer patients with concurrent diabetes, particularly for breast [pooled relative risk (RR) 0.70, 95% CI 0.55, 0.88; p = 0.003], colorectal (RR 0.70, 95% CI 0.59, 0.84; p < 0.001), ovarian (RR 0.44, 95% CI 0.30, 0.64; p < 0.001) and endometrial cancer (RR 0.49, 95% CI 0.32, 0.73; p = 0.001). In addition, metformin was associated with lower risks of cancer-specific mortality.
The findings of this study support the hypothesis that metformin improves the survival for cancer patients with concurrent diabetes, particularly for breast, colorectal, ovarian, and endometrial cancer. Further investigation is warranted.
流行病学研究和基础科学的新证据表明二甲双胍具有潜在的抗肿瘤作用。然而，二甲双胍是否能提高癌症患者的生存率仍无定论。
使用PubMed、EMbase和SciVerse Scopus数据库进行文献检索。采用随机效应荟萃分析模型得出合并效应估计值。
在检索到的28项研究中，合并效应估计值显示，二甲双胍与合并糖尿病的癌症患者全因死亡率较低相关，尤其是乳腺癌[合并相对风险（RR）0.70，95%置信区间0.55，0.88；p = 0.003]、结直肠癌（RR 0.70，95%置信区间0.59，0.84；p < 0.001）、卵巢癌（RR 0.44，95%置信区间0.30，0.64；p < 0.001）和子宫内膜癌（RR 0.49，95%置信区间0.32，0.73；p = 0.001）。此外，二甲双胍与癌症特异性死亡率较低相关。
本研究结果支持以下假设，即二甲双胍可提高合并糖尿病的癌症患者的生存率，尤其是乳腺癌、结直肠癌、卵巢癌和子宫内膜癌患者。有必要进行进一步研究。
