二甲双胍对胃癌合并2型糖尿病患者预后影响的Meta分析

Meta-analysis of the effect of metformin on the prognosis of patients with gastric cancer complicated with type 2 diabetes mellitus

目的:系统评价二甲双胍对胃癌合并2型糖尿病患者预后的影响。方法:计算机检索Pubmed、Cochrane library、Embase、知网、万方、维普等数据库,由两名研究员根据纳入、排除标准分别对检索文献进行筛选、质量评价及数据提取。使用RevMan5.4软件对总体生存率、癌症特异性生存率、无复发生存率进行Meta分析,效应量为风险比(hazard ratio,HR),各效应量以95%置信区间(confidence interval,CI)表示。结果:总共纳入10项研究,共计2522例患者。Meta分析的结果显示,与未使用二甲双胍的患者相比,二甲双胍的使用能够提高胃癌合并2型糖尿病患者的总生存期(HR=0.71,95%CI:0.63~0.80,P<0.00001)、癌症特异性生存期(HR=0.76,95%CI:0.65~0.90,P=0.001)及无复发生存期(HR=0.58,95%CI:0.47~0.72,P<0.00001)。结论:与非二甲双胍治疗相比,接受二甲双胍治疗的胃癌合并2型糖尿病患者能够改善预后,总生存期、癌症特异性生存期及无复发生存期得到延长。

Objective:To systematically evaluate the effect of metformin on the prognosis of patients with gastric cancer complicated with type 2 diabetes mellitus.Methods:Pubmed,Cochrane library,Embase,CNKI,WAN FANG,VIP were searched by computer.The search data was from the establishment of the database to January 2021.According to the inclusion and exclusion criteria,two researchers screened,evaluated and extracted the data.The overall survival,cancer-specific survival and recurrence-free survival were analyzed by Meta using RevMan5.4.The effect was expressed by 95%confidence interval(95%CI)as risk ratio(HR).Results:A total of 10 studies were included,with a total of 2522 patients.The results of Meta-analysis showed that metformin could improve the overall survival(HR=0.71,95%CI:0.63~0.80,P<0.00001),cancer-specific survival(HR=0.76,95%CI:0.65~0.90,P=0.001)and recurrence-free survival(HR=0.58,95%CI:0.47~0.72,P<0.00001)in patients with gastric cancer complicated with type 2 diabetes compared with patients without metformin.Conclusion:Compared with non-metformin treatment,metformin-treated gastric cancer patients with type 2 diabetes can improve the prognosis and overall survival,cancer-specific survival and recurrence-free survival.