二甲双胍抗肿瘤机制的研究进展

近年来，很多研究发现糖尿病能增加癌症的发生率和死亡率。目前，二甲双胍是临床治疗糖尿病的最常用药物之一。大量研究表明二甲双胍除具有降糖作用外，还有抑制肿瘤细胞生长的作用，因此可以降低2型糖尿病患者恶性肿瘤的发生率和死亡率。二甲双胍能激活腺苷活化蛋白激酶（AMPK）途径、阻滞细胞周期、调节胰岛素/IGF-1轴、调节肿瘤细胞的自噬效应、抑制肿瘤血管生成、激活体内免疫系统、增加化疗药物敏感性及杀伤肿瘤干细胞，从而杀灭肿瘤细胞，抑制肿瘤生长。二甲双胍具有安全、低毒的特性，将其应用于肿瘤的辅助治疗，可能会明显减轻化疗药物的毒副作用，提高患者的耐受性，并有望成为一种新型抗肿瘤药物。目前，二甲双胍的抗肿瘤机制仍处于实验及流行病学研究阶段，并未进入临床实验阶段，但其抗肿瘤作用是确切的。

Advance in the anti-tumor mechanism of metformin

In recent years,most studies indicated that diabetes could increase the cancer incidence and mortality.At present,metformin is one of the most commonly used drugs in the treatment of diabetes.Lots of studies suggested that metformin not only had hypoglycemic effect,also had a significant inhibition in tumor cell growth.So it could reduce cancer incidence and mortality in patients with type 2 diabetes.Metformin could activate the AMPK pathway,block the cell cycle,regulate insulin/IGF-1 axis,regulate autophagy and its roles in tumor cells,inhibit tumor angiogenesis,activate the immune system,increase the sensitivity of chemotherapeutic drugs and kill tumor stem cells,thus it could kill tumor cells and inhibit the growth of tumors.Metformin is safe and low toxic,if applied in the adjuvant therapy of cancer,it may significantly reduce the side-effects of anticarcinogen,but enhance the chemotherapy tolerance of patients.So it is expected to become a new kind of antitumor drug.At present,the anti-tumor mechanism of metformin is still in the experimental and epidemiologic research stage,it has not entered the stage of clinical trials,but the antitumor effect is exact.