二甲双胍治疗糖尿病合并新发肝癌患者的远期疗效

The long-term efficacy of metformin in the treatment of diabetes complicated with newly-onset hepatocellular carcinoma

目的探讨二甲双胍治疗糖尿病合并新发肝癌患者的远期疗效。方法采用回顾性病例对照研究方法。收集2011年1月—2012年7月郑州大学第一附属医院收治的146例糖尿病合并新发肝癌患者的临床资料。根据在肝癌首次诊断后是否持续使用二甲双胍超过90d,将患者分为二甲双胍组和非二甲双胍组。比较2组患者的临床资料及生存率,评价其疗效。结果2组患者临床资料具有基线可比性。2组患者总体生存率差异比较有统计学意义(χ^2=4.667,P=0.031);1年和3年总体生存率差异比较无统计学意义(P>0.05),5年总体生存率二甲双胍组明显高于非二甲双胍组(P<0.05)。2组患者无瘤生存率差异比较有统计学意义(χ^2=6.145,P=0.013);1年无瘤生存率差异比较无统计学意义(P>0.05),3年和5年无瘤生存率二甲双胍组明显高于非二甲双胍组(P<0.05)。结论二甲双胍组患者的总体生存率和无瘤生存率均明显优于非二甲双胍组患者,二甲双胍在治疗糖尿病合并新发肝癌上具有良好的远期疗效。

Objective To investigate the long-term efficacy of metformin in the treatment of diabetes complicated with newly-onset hepatocellular carcinoma(HCC). Methods The retrospective case-control study was conducted. The medical records of 146 patients with diabetes complicated with newly-onset HCC at the First Affiliated Hospital of Zhengzhou University between January 2011 and July 2012 were collected. We divided the patients into the following two categories: diabetics not on metformin or who discontinued metformin within 90 d of HCC diagnosis (the non-metformin group), and diabetics who continued metformin beyond 90 d after HCC diagnosis (the metformin group). The medical records and survival data between the two groups were compared. Results The data between the two groups were comparable (all P >0.05). The overall survival difference between the two groups was statistically significant (χ^2=4.667, P =0.031). The 1-year and 3-year overall survival were not significantly different (all P >0.05), though the 5-year cumulative survival rate was significantly different ( P <0.05). The disease-free survival difference between the two groups was statistically significant (χ^2 =6.145, P =0.013). The 1-year disease-free survival was not significantly different ( P >0.05), though the 3-year and 5-year recurrence-free survival rates were better in metformin groap than non-metformin group (all P <0.05). Conclusion The overall survival and the disease-free survival of the metformin group were significantly better than those of the non-metformin group. Metformin has a good long-term effect on the treatment of diabetes complicated with newly-onset HCC.