Li Peiwen, Zhang Cong, Gao Peng, Chen Xiaowan, Ma Bin, Yu Dehao, Song Yongxi, Wang Zhenning
Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China.
Oncol Lett. 2018 Jan;15(1):1191-1199. doi: 10.3892/ol.2017.7370. Epub 2017 Nov 8.
Increasing evidence suggests that metformin use is associated with a decreased risk of cancer. The traditional therapies for gastric cancer (GC) are gastrectomy and chemoradiotherapy; however, these therapies may cause certain adverse effects, which affect a patient's quality of life, and the overall survival rate is low. At present, little is known about whether the use of metformin decreases the risk of GC in patients with type 2 diabetes. Therefore, in the present study, a systematic review was performed to analyze the effect of metformin on GC. A literature search was conducted in PubMed, EMBASE, and the Cochrane Library databases for articles published up to June 30th, 2016. The studies that evaluated GC patients treated with metformin and compared them with GC patients treated with other antidiabetic drugs were reviewed. Eligible studies were evaluated using the Newcastle-Ottawa Scale. Adjusted hazard ratio and 95% confidence intervals were determined to evaluate the effect of metformin on GC. From the 422 articles evaluated, 5 studies involving a total of 1,804,479 patients met the inclusion criteria and were qualitatively analyzed. The quality of all selected articles was classified as moderate. These studies reported that the long-term use of metformin was associated with a lower risk of GC compared with the lack of use of metformin or the use of other hypoglycemic drugs. In GC patients with diabetes who were subjected to gastrectomy, the cumulative use of metformin reduced the rates of disease recurrence and of all-cause and cancer-specific mortality. Despite the limited number of studies on this subject, currently available evidence indicates that metformin is associated with a decreased risk of GC and improves survival in patients with type 2 diabetes. However, more well-designed trials are required to elucidate this association.
越来越多的证据表明，使用二甲双胍与降低癌症风险有关。胃癌（GC）的传统治疗方法是胃切除术和放化疗；然而，这些治疗可能会引起某些不良反应，影响患者的生活质量，且总体生存率较低。目前，对于二甲双胍的使用是否能降低2型糖尿病患者患GC的风险知之甚少。因此，在本研究中，进行了一项系统评价以分析二甲双胍对GC的影响。在PubMed、EMBASE和Cochrane图书馆数据库中检索截至2016年6月30日发表的文章。对评估接受二甲双胍治疗的GC患者并将其与接受其他抗糖尿病药物治疗的GC患者进行比较的研究进行了综述。使用纽卡斯尔-渥太华量表对符合条件的研究进行评估。确定调整后的风险比和95%置信区间以评估二甲双胍对GC的影响。从评估的422篇文章中，有5项研究共涉及1,804,479名患者符合纳入标准并进行了定性分析。所有入选文章的质量均被归类为中等。这些研究报告称，与未使用二甲双胍或使用其他降糖药物相比，长期使用二甲双胍与较低的GC风险相关。在接受胃切除术的糖尿病GC患者中，二甲双胍的累积使用降低了疾病复发率以及全因死亡率和癌症特异性死亡率。尽管关于该主题的研究数量有限，但现有证据表明二甲双胍与降低GC风险相关，并可提高2型糖尿病患者的生存率。然而，需要更多设计良好的试验来阐明这种关联。
