Effects of metformin on survival outcomes of lung cancer patients with type 2 diabetes mellitus: a meta-analysis
Effects of metformin on survival outcomes of lung cancer patients with type 2 diabetes mellitus: a meta-analysis
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DOI：
10.1007/s12094-015-1412-x
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发表时间：
2016-06-01
影响因子：
3.4
通讯作者：
Ji, H. -L.
中科院分区：
文献类型：
--
作者：
Tian, R. -H.;Zhang, Y. -G.;Ji, H. -L.
二甲双胍对不同类型肺癌的抗癌作用已被广泛研究。然而，二甲双胍与2型糖尿病患者肺癌预后的关系仍存在争议。利用PubMed/Medicine、EMBASE和Cochrane图书馆数据库进行电子检索。根据 I (2) 统计检验的异质性，使用随机效应或固定效应模型进行统计分析。当前的荟萃分析中纳入了涉及 2350 名患者的六项研究。总而言之，总生存期 (OS) 的汇总 HR 为 0.90 (95% CI 0.84-0.96；P = 0.003)。亚组分析显示，按地区分层时，亚洲和西方国家的 OS HR 分别为 0.52 (95% CI 0.31-0.87；P = 0.012) 和 0.86 (95% CI 0.67-1.11，P = 0.361)。按研究设计分层时，队列研究和基于医学数据的研究的 OS HR 分别为 0.78（95% CI 0.52-1.15，P = 0.206）和 0.82（95% CI 0.59-1.16，P = 0.264）。按肺癌亚型分层时，SCLS、NSCLC 和 NSCLC 的 OS HR 分别为 0.52 (95% CI 0.31-0.87；P = 0.012)、1.06 (95% CI 0.51-2.19；P = 0.878) 和 0.82 (95% CI 0.59-1.16；P = 0.264)。不分亚型，分别。二甲双胍的使用 可能与患有 2 型糖尿病的肺癌患者的良好预后相关，但效果有限。然而，它可以在肺癌患者的选择性亚组中获益，尤其是来自亚洲的 SCLC 患者。需要进一步的研究来证实这种功效。
Anti-cancer effect of metformin on different kinds of lung cancer has been studied frequently. However, the association between metformin and the prognosis of lung cancer in type 2 diabetes patients is still controversial.An electronic search was conducted using PubMed/Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity examined by I (2) statistics.Six studies involving 2350 patients were included in the current meta-analysis. In all, the pooled HR of overall survival (OS) was 0.90 (95 % CI 0.84-0.96; P = 0.003). Sub-group analysis showed that when stratified by region the HR of OS was 0.52 (95 % CI 0.31-0.87; P = 0.012) and 0.86 (95 % CI 0.67-1.11, P = 0.361) for Asian and Western countries. When stratified by study design, the HR of OS was 0.78 (95 % CI 0.52-1.15, P = 0.206) and 0.82 (95 % CI 0.59-1.16, P = 0.264) for cohort and medical data-based studies. When stratified by lung cancer subtype, HR of OS was 0.52 (95 % CI 0.31-0.87; P = 0.012), 1.06 (95 % CI 0.51-2.19; P = 0.878) and 0.82 (95 % CI 0.59-1.16; P = 0.264) for SCLS, NSCLC and non-divided subtypes, respectively.Metformin use may associate with a good prognosis in lung cancer patients with type 2 diabetes but the effect was modest. However, it could achieve benefits in a selective sub-group of lung cancer patients especially in SCLC patients from Asian. Further studies are warranted to confirm this efficacy.