对于患有 II 型糖尿病的结直肠癌患者，二甲双胍能否提高生存率？一项荟萃分析。

For colorectal cancer patients with type II diabetes, could metformin improve the survival rate? A meta-analysis.

机构信息

Department of Coloproctology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

Department of Gastrointestinal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Clin Res Hepatol Gastroenterol. 2020 Feb;44(1):73-81. doi: 10.1016/j.clinre.2019.06.009. Epub 2019 Jul 9.

DOI:10.1016/j.clinre.2019.06.009

PMID:31300371

Abstract

OBJECTIVE

Current research is controversial about whether metformin can improve the survival rate of patients with colon cancer. Therefore, we conducted a meta-analysis to identify the association between metformin and the survival rate of colorectal cancer (CRC) patients with type II diabetes.

METHODS

We conducted a search in databases including Pubmed, EMBASE and Cochrane Library. All articles were published in the last decade, and the quality of each study was evaluated by the Newcastle-Ottawa Scale. Odds ratios (ORs) and its corresponding 95% confidence intervals (CIs) for each study were calculated and summary relative risk estimates with corresponding 95% CIs were generated using the random-effects model. Heterogeneity and publication bias were assessed.

RESULTS

Ten articles were included in this meta-analysis. The included articles were all cohort studies. In a pooled analysis of all studies, metformin using was associated with increased overall survival (OS) rate (OR, 0.54; 95% CI, 0.47 to 0.63) and cancer-specific survival (CS) rate (OR 0.59; 95% CI 0.43 to 0.82) of CRC patients with diabetes. We found that the effect of metformin is associated with geographical region through subgroup meta-analysis.

CONCLUSIONS

Metformin using was associated with an increased OS rate and CS rate of colorectal cancer.

摘要

目的

目前的研究对于二甲双胍是否能提高结肠癌患者的生存率存在争议。因此，我们进行了一项荟萃分析，以确定二甲双胍与 II 型糖尿病结直肠癌（CRC）患者生存率之间的关系。

方法

我们在包括 Pubmed、EMBASE 和 Cochrane Library 在内的数据库中进行了检索。所有文章均发表在过去十年内，每个研究的质量均由 Newcastle-Ottawa 量表进行评估。使用随机效应模型计算每个研究的优势比（OR）及其相应的 95%置信区间（CI），并生成汇总相对风险估计值及其相应的 95%CI。评估了异质性和发表偏倚。

结果

本荟萃分析纳入了 10 篇文章。纳入的文章均为队列研究。在所有研究的汇总分析中，使用二甲双胍与增加总体生存率（OS）率（OR，0.54；95%CI，0.47 至 0.63）和癌症特异性生存率（CS）率（OR 0.59；95%CI 0.43 至 0.82）相关。我们通过亚组荟萃分析发现，二甲双胍的作用与地理位置有关。