二甲双胍对糖尿病并发肾癌患者生存结果影响的Meta分析

目的:运用Meta分析来评估二甲双胍对糖尿病并发肾癌患者生存结果影响.方法:检索PubMed、EMbase、CNKI等数据库,筛选并纳入相关文献,提取文献特征,采用Review Manager 5.3软件计算总的风险比(HR)及95%CI,并评价研究间的异质性、有无发表偏倚.结果:共纳入5篇队列研究.根据肾癌局部与转移的亚组分析结果显示二甲双胍对肾癌患者的PFS无显著改善作用(HR=0.78,95%CI:0.42~1.45,P=0.43)、(HR=0.98,95%CI:0.81~1.19,P=0.84),同样对CSS、OS也无显著影响(HR=0.59,95%CI:0.22~1.58,P=0.30)、(HR=0.78,95%CI:0.50~1.22,P=0.28),(HR=1.01,95%CI:0.71~1.43,P=0.96)、(HR=1.05,95%CI:0.83~1.33,P=0.68).发表偏倚结果显示不存在发表偏倚(Begg:P=0.658;Egger:P=0.765).结论:本项Meta分析显示二甲双胍对于肾癌患者的生存结果无显著改善作用.

A Meta-analysis on the effect of metformin on the survival in diabetic patients with renal cell cancer

Objective:To evaluate the effect of metformin on survival indiabetes mellitus patients complicated with renal cell carcinoma (RCC)by Meta-analysis.Methods:Multiple database were searched to identify studies on the association between use of metformin and survival of renal cell carcinoma.Relevant information for analysis was extracted.A random-effects model was used to calculate the pooled risk estimate and its 95% confidence interval(CI).Heterogeneity across studies and publication bias were tested.Results:5 cohort studies were included.Subgroup analysis by the localized renal cancer and the metastatic showed that there was no significant improvement in PFS (HR=0.78,95%CI:0.42~1.45,P=0.43),(HR=0.98,95%CI:0.81~1.19,P=0.84),but also had no significant effect on CSS and OS (HR=0.59,95%CI:0.22~1.58,P=0.30),(HR=0.78,95%CI: 0.50~1.22,P=0.28),(HR=1.01,95%CI:0.71~1.43,P=0.96),(HR=1.05,95%CI:0.83~1.33,P=0.68).The publication bias showed no publication bias (Begg,P=0.658;Egger,P=0.765).Conclusion:This Meta-analysis showed that metformin did not significantly improve survival outcomes in patients with renal cell carcinoma.