二甲双胍对妇科肿瘤预后影响的meta分析

摘要

目的：探讨二甲双胍对妇科肿瘤（卵巢癌、子宫内膜癌）预后的影响。方法检索2015年7月1日前PubMed 和EMbase数据库中二甲双胍影响妇科肿瘤预后的文献，预后指标包括：总体生存率、肿瘤无进展/无复发生存率及肿瘤特异性生存率，使用随机效应模型来合并效应指标。结果二甲双胍能改善子宫内膜癌患者预后的总体生存率（OS）（HR 0.49，95% CI 0.39~0.61），无进展生存率（PFS）（HR 0.56，95% CI 0.36~0.87），无复发生存率（RFS）（HR 0.59，95% CI 0.42~0.83）及卵巢癌的OS（HR 0.48，95% CI 0.32~0.73），PFS（HR 0.38，95% CI 0.16~0.90），CS（HR 0.37，95% CI 0.19~0.72）。结论二甲双胍可能改善合并糖尿病的卵巢癌和子宫内膜癌患者的预后，尤其是子宫内膜样癌及上皮性卵巢癌，但尚需进一步的临床试验对其进行研究论证。%ObjectiveThis study aims to make a meta-analysis for the prognosis value of metformin on gynecological tumors(ovarian cancer and endometrial cancer).MethodsWe performed systematic searches using electronic databases including PubMed and EMbase until July 20, 2014,all human studies assessing metformin for effecting the prognosis of patients with gynecological tumors were eligible for inclusion,metformin use on prognosis related outcomes(OS:overall survival;PFS/RFS:progression/recurrence free survival;CS:cancer specific survival)were merged using random effects model.ResultsOverall,metformin use was also associated with an improved OS(HR 0.49,95% CI 0.39–0.61), PFS(HR 0.56,95% CI 0.36–0.87),RFS(HR 0.59,95% CI 0.42–0.83)of endometrial cancer cases and OS(HR 0.48,95% CI 0.32–0.73), PFS(HR 0.38,95% CI 0.16–0.90),CS(HR 0.37,95% CI 0.19–0.72)of ovarian cancer.ConclusionsMetformin may improves the survival for ovarian cancer and endometrial cancer patients with concurrent diabetes,especially for endometrioid endometrial cancer and epithelial ovarian cancer, further well-conducted controlled clinical trials is warranted.