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二甲双胍与结直肠癌——一项系统评价

Metformin and Colorectal Cancer - A Systematic Review.

作者信息

Kobiela Jarek, Dobrzycka Małgorzata, Jędrusik Piotr, Kobiela Paulina, Spychalski Piotr, Śledziński Zbigniew, Zdrojewski Tomasz

机构信息

Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland.

Department of Internal Medicine, Hypertension, and Angiology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Exp Clin Endocrinol Diabetes. 2019 Jul;127(7):445-454. doi: 10.1055/a-0621-8830. Epub 2018 Jun 28.

Abstract

OBJECTIVES

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths. The development of preventive strategies in CRC has been the subject of much research. Multiple studies have shown an association between diabetes and CRC. In addition to its glucose-lowering properties, metformin might have an additional role in the prevention and treatment of CRC. OUR OBJECTIVE: was to summarize findings on role of metformin in colorectal cancer.

METHODS

We conducted a systematic review of the PubMed and Cochrane databases from January 2005 to December 2017 in search for studies on the association between metformin and CRC.

RESULTS

Of the total of 189 studies identified by the search, we excluded 123 studies and reviewed the remaining 66 studies on cell lines, animals, patients with diabetes, and healthy subjects. In vitro and animal studies have shown a protective effect of metformin use on the incidence of CRC and amplification of the therapeutic effects of CRC chemotherapy. Studies on patients with type 2 diabetes treated with metformin analyzed data on total of 146 496 patients. The results of those studies on the role of metformin in CRC suggest risk reduction and potential applications within therapeutic regimens, although some of those are conflicting.

CONCLUSION

Further studies are warranted to define the role of metformin in both prevention and treatment of CRC.

摘要

目的

结直肠癌(CRC)是癌症相关死亡的第二大主要原因。结直肠癌预防策略的制定一直是众多研究的主题。多项研究表明糖尿病与结直肠癌之间存在关联。除了其降血糖特性外,二甲双胍可能在结直肠癌的预防和治疗中发挥额外作用。我们的目的是总结二甲双胍在结直肠癌中作用的研究结果。

方法

我们对2005年1月至2017年12月的PubMed和Cochrane数据库进行了系统综述,以寻找关于二甲双胍与结直肠癌关联的研究。

结果

在检索到的总共189项研究中,我们排除了123项研究,并对其余66项关于细胞系、动物、糖尿病患者和健康受试者的研究进行了综述。体外和动物研究表明,使用二甲双胍对结直肠癌的发病率具有保护作用,并可增强结直肠癌化疗的治疗效果。对接受二甲双胍治疗的2型糖尿病患者的研究分析了总共146496名患者的数据。这些关于二甲双胍在结直肠癌中作用的研究结果表明,二甲双胍可降低风险并在治疗方案中具有潜在应用,尽管其中一些结果相互矛盾。

结论

有必要进一步研究以确定二甲双胍在结直肠癌预防和治疗中的作用。

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