二甲双胍对2型糖尿病合并前列腺癌患者生存率及无复发率影响的Meta分析

目的:系统评价二甲双胍对2型糖尿病并发前列腺癌患者生存结果的影响。方法:通过检索Pubmed、Embase和Cochrane这三个数据库。按照纳入、排除标准，由2名作者进行文献筛选、文献质量评估及数据提取，使用Review Manager 5.3软件对总体生存期（overall-survival,OS）、癌症相关生存期（cancer-specific survival,CSS）、无复发生存期（recurrence-free survival,RFS）进行分析，并把风险比（HR）作为效应量，各效应量以95%可信区间（confidence Interval，CI）表示。结果:共纳入22篇文献，共389 584例患者。Meta分析显示:与未使用二甲双胍治疗相比，使用二甲双胍能够明显提高前列腺癌患者OS（HR=0.74，95%CI:0.61～0.90,P=0.003）、CSS（HR=0.74，95%CI:0.62～0.87,P=0.000 3）及RFS（HR=0.72，95%CI:0.57～0.92，P=0.008）。结论:相比非二甲双胍治疗组，接受二甲双胍治疗的前列腺癌合并2型糖尿病患者，能够获得更好的总体生存期、癌症相关生存期以及无复发生存期。

A Meta-analysis of the effects of metformin on survival and recurrence-free survival in diabetic patients combined with prostate cancer

Objective:To evaluate the association of the metformin treatment on survival intype 2 diabetes mellitus patients complicated with prostate cancer by Meta analysis.Methods:PubMed,Embase and Cochrane library databases were searched to identify studies,which conformined to the standards of inclusion and exclusion,by two authors.The adjusted risk estimates and were extracted by this two authors.The results were included overall survival (OS),cancer-specific survival (CSS) and recurrence-free survival (RFS),which were measures as hazard (HR) with 95% confidence interval (95%CI) by Review Manager 5.3 software.Results:A total of twenty-two cohort studies involved 389 584 patients were included in this Meta study.Our Meta-analysis showed that the treatment of metformin could improve the overall survival,cancer-specific survival and recurrence-free survival in prostate cancer with type 2 diabetes mellitus （HR=0.74，95%CI:0.61~0.90,P=0.003）,（HR=0.74，95%CI:0.62~0.87,P=0.000 3） and （HR=0.72，95%CI:0.57~0.92,P=0.008）,compared with no-metformin treatment.Conclusion:Compared with no-metformin treatment,meformin can significantly improve the overall survival,cancer-specific survival and recurrence-free survival in patients with prostate cancer and type 2 diabetes mellitus.