二甲双胍对 2 型糖尿病患者胃癌的影响：系统评价和荟萃分析。
The effect of metformin on gastric cancer in patients with type 2 diabetes: a systematic review and meta-analysis.
机构信息
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Road, Donghu District, Nanchang, 330006, Jiangxi, People's Republic of China.
First Clinical Medical College, Nanchang University, Nanchang, 330006, People's Republic of China.
出版信息
Clin Transl Oncol. 2020 Sep;22(9):1580-1590. doi: 10.1007/s12094-020-02304-y. Epub 2020 Feb 14.
BACKGROUND
Metformin, a drug widely used in the treatment of diabetes, has proven preventive and survival benefits for various malignancies. However, the effect of metformin on gastric cancer risk and survival rate in T2DM patients remains controversial. Therefore, we conducted a systematic review and meta-analysis to evaluate the effect of metformin on gastric cancer in T2DM patients.
METHODS
We searched PubMed, EMBASE, Medline and the Cochrane Library for related studies up to October 22, 2019. Pooled hazard ratios with 95% confidence intervals were calculated using random-effects model. Heterogeneity was assessed. All articles were evaluated by Newcastle-Ottawa Scale.
RESULTS
A total of 11 cohort studies met eligibility criteria and were included in the meta-analysis. The use of metformin was related to a significant 21% reduction in GC incidence (HR 0.790; 95% CI 0.624-1.001). Subgroup analysis showed that the use of metformin significantly reduced the risk of gastric cancer in T2DM patients in Asian populations, but not in western populations. In a pooled analysis of 3 studies, metformin use was associated with increased overall survival rate (HR 0.817; 95% CI 0.600-1.113) and cancer-specific survival rate (HR 0.824; 95% CI 0.614-1.106) of T2DM patients.
CONCLUSIONS
Metformin could reduce the risk of gastric cancer in T2DM patients, particularly in Asian populations. However, it is debatable whether metformin use can improve the prognosis of gastric cancer in T2DM patients.
背景
二甲双胍是一种广泛用于治疗糖尿病的药物，已被证明对多种恶性肿瘤具有预防和生存获益。然而，二甲双胍对 T2DM 患者胃癌风险和生存率的影响仍存在争议。因此，我们进行了系统评价和荟萃分析，以评估二甲双胍对 T2DM 患者胃癌的影响。
方法
我们检索了 PubMed、EMBASE、Medline 和 Cochrane 图书馆截至 2019 年 10 月 22 日的相关研究。使用随机效应模型计算合并的危险比及其 95%置信区间。评估异质性。所有文章均采用 Newcastle-Ottawa 量表进行评估。
结果
共有 11 项队列研究符合纳入标准并纳入荟萃分析。二甲双胍的使用与 GC 发生率显著降低 21%相关（HR 0.790；95%CI 0.624-1.001）。亚组分析显示，在亚洲人群中，二甲双胍的使用显著降低了 T2DM 患者患胃癌的风险，但在西方人群中则不然。在 3 项研究的汇总分析中，二甲双胍的使用与 T2DM 患者的总生存率（HR 0.817；95%CI 0.600-1.113）和癌症特异性生存率（HR 0.824；95%CI 0.614-1.106）的增加相关。
结论
二甲双胍可降低 T2DM 患者胃癌的风险，特别是在亚洲人群中。然而，二甲双胍的使用是否能改善 T2DM 患者胃癌的预后仍存在争议。
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