二甲双胍对卵巢癌患者生存的影响:一项荟萃分析

Impact of metformin on survival in patients with ovarian cancer:a meta-analysis

目的分析二甲双胍对卵巢癌患者生存率的影响,为降低癌症风险、提高患者生存率提供参考。方法搜索PubMed、Embase和Web of Science数据库自建库至2022-10-25的相关文献。搜索医学主题词和文本词包括metformin、biguanides、diabetic medications、ovarian、ovary、cancer、neoplasms、tumor、carcinoma、survival、mortality、prognosis、death,提取每项研究的数据和特征,并计算95%CI和HR值以评估二甲双胍对糖尿病卵巢癌患者总生存期(OS)和无进展生存期(PFS)的影响,最终纳入10篇文献。结果二甲双胍对卵巢癌患者生存率有显著益处,HR=0.59,95%CI:0.49~0.72。亚组分析显示二甲双胍可以改善糖尿病卵巢癌患者OS,HR=0.65,95%CI:0.53~0.81。但二甲双胍与糖尿病卵巢癌患者的PFS无关联,HR=0.48,95%CI:0.22~1.05。与无糖尿病卵巢癌患者相比,二甲双胍与糖尿病卵巢癌患者OS和PFS有关联,合并HR值分别为0.39(95%CI:0.20~0.76)和0.39(95%CI:0.26~0.57)。二甲双胍使用时间>720 d可以改善糖尿病卵巢癌患者的OS,HR=0.31,95%CI:0.16~0.57。二甲双胍与糖尿病卵巢癌患者的疾病特异性生存率无关,HR=0.59,95%CI:0.31~1.12。结论目前的研究初步证实二甲双胍可能与卵巢癌患者的生存获益相关,但需要更多的研究来证实。

Objective The effect of metformin on the survival rate of ovarian cancer patients was analyzed,which provided a reference for reducing the risk of cancer and improving the survival rate of patients.Methods We searched PubMed,Embase,and Web of Science databases as of 2022-10-25.The medical subject terms and text terms included metformin,biguanides,diabetic medications,ovarian,ovary,cancer,neoplasms,tumor,carcinoma,survival,mortality,prognosis and death.The data and features were extracted for each study,and 95%CI and HRvalues were calculated to assess the effects of metformin on overall survival(OS)and progression-free survival(PFS)in diabetic patients with ovarian cancer,and finally 10articles were included.Results Metformin had significant benefits on the survival rate of ovarian cancer patients,HR=0.59,95%CI:0.49-0.72.Subgroup analysis showed that metformin could improve OS in diabetic ovarian cancer patients,HR=0.65,95%CI:0.53-0.81.However,metformin was not associated with PFS in diabetic ovarian cancer patients,HR=0.48,95%CI:0.22-1.05.Compared with patients without diabetic ovarian cancer,metformin was associated with OS and PFS in diabetic ovarian cancer patients,and the combined HR values were 0.39(95%CI:0.20-0.76)and 0.39(95%CI:0.26-0.57),respectively.The use of metformin>720days can improve the OS of diabetic ovarian cancer patients,HR=0.31,95%CI:0.16-0.57.Metformin was not associated with disease-specific survival in diabetic ovarian cancer patients,HR=0.59,95%CI:0.31-1.12.Conclusion The current study has tentatively confirmed that metformin may be associated with survival benefits in patients with ovarian cancer,but more research is required for confirmation.