磺酰脲类药物对糖尿病患者胃癌发病风险及预后影响的Meta分析  

Risk and prognosis of gastric cancer in diabetic patients with sulfonylureas:A Meta-analysis

作　　者：马英骥 孙丽斌[1] 王莎莎[1] 王达 李晖[1] 邱文生[1] MA Yingji;SUN Libin;WANG Shasha;WANG Da;LI Hui;QIU Wensheng(Qingdao University Affiliated Hospital,Shandong Qingdao 266003,China)

机构地区：[1]青岛大学附属医院,山东青岛266003

出　　处：《现代肿瘤医学》2021年第8期1355-1360,共6页Journal of Modern Oncology

基　　金：北京市希思科临床肿瘤学研究基金会资助项目(编号:Y-HR2018-185)。

摘　　要：目的:评估磺酰脲类药物(sulfonylureas,SUs)对2型糖尿病患者罹患胃癌的发病风险及其预后的影响。方法:计算机检索PubMed、Web of Science和EMBASE数据库,收集关于2型糖尿病患者服用SUs对胃癌的发生风险及对胃癌患者预后影响的研究,检索时限为建库至2020年2月1日。对符合纳入标准的研究进行质量评价和数据提取,采用RevMan 5.3软件进行Meta分析。结果:共纳入了12篇文献。其中,10篇文献研究了SUs与胃癌的发生风险,Meta分析显示与使用非磺酰脲类药物相比,使用SUs能增加胃癌的发病风险(RR=1.43,95%CI 1.05~1.94,P<0.05);亚组分析显示,3项研究报道了SUs与二甲双胍相比胃癌的发生风险,结果显示与使用二甲双胍的患者相比,使用SUs的患者胃癌发生风险较高(RR=2.22,95%CI 1.75~2.81,P<0.00001);2项研究报道了SUs与胰岛素相比胃癌的发生风险,结果显示两组患者胃癌发生的风险无明显差异(RR=2.05,95%CI 0.49~8.55,P=0.33)。其余5项研究未具体阐明对照组降糖药物种类,该结果尚不能认为使用SUs可以降低胃癌的发病风险(RR=0.99,95%CI 0.98~1.00,P=0.006)。2篇文献研究了SUs对2型糖尿病合并胃癌患者的预后,Meta分析显示与使用非磺酰脲类药物相比,使用SUs对胃癌患者的总生存期(overall survival,OS)无明显影响(RR=1.36,95%CI 0.69~2.67)。结论:在2型糖尿病患者中,使用磺酰脲类药物作为降糖药物会增加胃癌的发生风险;此外,磺酰脲类药物不会影响2型糖尿病合并胃癌患者的预后情况。Objective:To evaluate the risk and prognosis of patients with type 2 diabetes with gastric cancer by using sulfonylureas.Methods:PubMed,Web of Science and EMBASE databases were searched by computer from inception to February 1,2020,to collect research on the risk of gastric cancer and prognosis in patients with type 2 diabetes by using sulfonylureas.Carry out quality evaluation and data extraction for the research that meets the inclusion criteria,RevMan 5.3 software was used for Meta-analyses.Results:A total of 12 articles were included.Among them,10 studies reported the occurrence risk of sulfonylureas and gastric cancer.Meta-analysis showed that compared with non-sulfonylureas,the use of sulfonylureas increased the risk of gastric cancer(RR=1.43,95%CI 1.05~1.94,P<0.05).Subgroup analysis showed that three studies reported the risk of gastric cancer in sulfonylureas compared with metformin,and the results showed that compared with metformin,patients using sulfonylureas had a higher risk of gastric cancer,with a statistically significant difference(RR=2.22,95%CI 1.75~2.81,P<0.00001).Two studies reported the risk of gastric cancer between SUs and insulin,and the results showed no significant difference in the risk of gastric cancer between the two groups(RR=2.05,95%CI 0.49~8.55,P=0.33).The control group of the other five studies only identified patients who did not use sulfonylureas,but did not specify the type of hypoglycemic drugs.This result does not suggest that sulfonylureas can reduce the risk of gastric cancer,with statistically significant differences(RR=0.99,95%CI 0.98~1.00,P=0.006).Two literatures studied the prognosis of sulfonylureas in patients with type 2 diabetes mellitus combined with gastric cancer.Meta-analysis showed that compared with non-sulfonylureas,the use of sulfonylureas had no significant effect on overall survival(OS)in patients with gastric cancer(RR=1.36,95%CI 0.69~2.67).Concusion:In patients with type 2 diabetes,the use of sulfonylureas as hypoglycemic drugs can increase the risk of

关 键 词：磺酰脲类 2型糖尿病 胃癌 META分析 

分 类 号：R735.2[医药卫生—肿瘤]