Berkovic Maja Cigrovski, Mikulic Danko, Bilic-Curcic Ines, Mrzljak Anna
Department of Kinesiological Anthropology and Methodology, Faculty of Kinesiology, University of Zagreb, Zagreb 10000, Croatia.
Department of Surgery, Merkur University Hospital, Zagreb 10000, Croatia.
World J Gastroenterol. 2021 Apr 14;27(14):1362-1368. doi: 10.3748/wjg.v27.i14.1362.
Colorectal cancer (CRC) is among the most prevalent cancers worldwide, and its prevention and reduction of incidence is imperative. The presence of diabetes has been associated with a 30% increased risk of CRC, likely through the mechanism of hyperinsulinemia, which promotes tumorigenesis the insulin receptor in the epithelium or by insulin-like growth factor pathways, inflammation, or adipokines, inducing cancer cell proliferation and cancer spread. Metformin, the first-line agent in treating type 2 diabetes, has a chemopreventive role in CRC development. Additionally, preclinical studies suggest synergistic effects of metformin with oxaliplatin in inhibiting models of colon cancer. Although preclinical studies on the post diagnostic use of metformin were promising and suggested its synergistic effects with chemotherapy, the data on the possible effects of metformin after surgery and other CRC treatment in the clinical setting are less conclusive, and randomized controlled trials are still lacking.
结直肠癌（CRC）是全球最常见的癌症之一，预防和降低其发病率势在必行。糖尿病的存在与结直肠癌风险增加30%相关，可能是通过高胰岛素血症机制，该机制通过上皮细胞中的胰岛素受体或胰岛素样生长因子途径、炎症或脂肪因子促进肿瘤发生，诱导癌细胞增殖和扩散。二甲双胍是治疗2型糖尿病的一线药物，在结直肠癌发生发展中具有化学预防作用。此外，临床前研究表明二甲双胍与奥沙利铂在抑制结肠癌模型方面具有协同作用。尽管关于二甲双胍诊断后使用的临床前研究前景良好，并表明其与化疗具有协同作用，但关于二甲双胍在临床环境中手术后及其他结直肠癌治疗后的可能效果的数据尚不确凿，且仍缺乏随机对照试验。
