Wojciechowska J, Krajewski W, Bolanowski M, Kręcicki T, Zatoński T
Department and Clinic of Otolaryngology, Head and Neck Surgery, Wrocław Medical University Hospital, Borowska 213, Wrocław.
Department and Clinic of Urology, Wrocław Medical University Hospital, Borowska 213, Wrocław.
Exp Clin Endocrinol Diabetes. 2016 May;124(5):263-75. doi: 10.1055/s-0042-100910. Epub 2016 May 24.
Diabetes mellitus (DM), one of the most common life-threatening illnesses worldwide, is a group of metabolic diseases, characterized by sustained hyperglycemia. The global prevalence of diabetes mellitus among adults reached 387 millions in 2014 and is still rising. It is suggested there is a strong association between diabetes mellitus (especially type 2 diabetes mellitus) and carcinogenesis. The possible biological links between diabetes mellitus and cancer comprise hyperinsulinemia, hyperglycemia and fat-induced chronic inflammation. Although, the strongest association refers to pancreas and liver, there are many other organs involved in carcinogenesis in diabetic patients including breast, endometrium, bladder and kidney.Recent studies suggest that there is also association between cancer incidence and anti-diabetic medications. It was observed that some medications decrease the risk of carcinogenesis and some increase that risk. The majority of studies concern metformin, a drug of choice in type 2 diabetes mellitus, and its anti-neoplastic and tumor-suppressing activity. The positive effect of metformin was found in numerous researches investigating breast, pancreas, liver, colon, ovaries and prostate tumors.Because a variety of studies have suggested that diabetes mellitus and cancer are frequently coexisting diseases, recently published studies try to explain the influence of diabetes mellitus and anti-diabetic medications on carcinogenesis in different organs.We present the review of the latest studies investigating the association between both diabetes mellitus and anti-diabetic medications and cancer incidence and prognosis.Particularly we highlight the problem of concomitant head and neck cancers in diabetics, rarely analysed and often omitted in studies.
糖尿病(DM)是全球最常见的危及生命的疾病之一,是一组以持续性高血糖为特征的代谢性疾病。2014年全球成年人糖尿病患病率达到3.87亿,且仍在上升。有研究表明糖尿病(尤其是2型糖尿病)与癌症发生之间存在密切关联。糖尿病与癌症之间可能的生物学联系包括高胰岛素血症、高血糖和脂肪诱导的慢性炎症。虽然,最强的关联涉及胰腺和肝脏,但糖尿病患者发生癌症的过程中还涉及许多其他器官,包括乳腺、子宫内膜、膀胱和肾脏。最近的研究表明,癌症发病率与抗糖尿病药物之间也存在关联。据观察,一些药物可降低癌症发生风险,而一些药物则会增加该风险。大多数研究关注二甲双胍,这是2型糖尿病的首选药物,及其抗肿瘤和抑癌活性。在众多针对乳腺、胰腺、肝脏、结肠、卵巢和前列腺肿瘤的研究中均发现了二甲双胍的积极作用。由于各种研究表明糖尿病和癌症常常并存,最近发表的研究试图解释糖尿病和抗糖尿病药物对不同器官癌症发生的影响。我们对调查糖尿病和抗糖尿病药物与癌症发病率及预后之间关联的最新研究进行综述。特别是,我们强调了糖尿病患者并发头颈癌的问题,该问题在研究中很少被分析且常常被忽略。