二甲双胍延缓前列腺癌进展的回顾性研究  

Metformin delays progression of prostate cancer:a retrospective study on 192 cases

作　　者：谭信韬 刘秋礼 彭松 张军[1] 张尧[1] 江军[1] TAN Xintao;LIU Qiuli;PENG Song;ZHANG Jun;ZHANG Yao;JIANG Jun(Department of Urology,Daping Hospital,Army Medical University(Third Military Medical University),Chongqing,400042,China)

机构地区：[1]陆军军医大学(第三军医大学)大坪医院泌尿外科,重庆400042

出　　处：《第三军医大学学报》2021年第13期1253-1257,共5页Journal of Third Military Medical University

基　　金：军队保健专项科研课题(17BJZ13);国家自然科学基金青年科学基金(81802558)。

摘　　要：目的探讨二甲双胍的使用对局限性前列腺癌根治术患者生化复发发生的影响以及骨转移性前列腺癌患者去势治疗抵抗发生的影响。方法回顾性分析2008年1月至2020年4月在本科确诊为局限性前列腺癌并行根治性手术且术后发生生化复发的患者31例和骨转移性前列腺癌患者161例,分别分为观察组(二甲双胍±抗雄药物治疗组)和对照组(无处理或单纯抗雄药物治疗组)。分别比较两组患者的基线特征,包括年龄、初始时前列腺特异性抗原(prostate specific antigen,PSA)、生化复发时PSA、病理T分期、Gleason评分。分析两组间生化复发或去势抵抗性前列腺癌(castration-resistant prostate cancer,CRPC)发生时间,前列腺特异性抗原倍增时间(prostate specific antigen double time,PSADT)和PSA最低值的差异。结果针对局限性前列腺癌根治术术后生化复发患者,观察组术后无生化复发中位时间(22.73个月)和平均PSADT时间(4.69个月)明显长于对照组术后无生化复发中位时间(10.73个月)和平均PSADT时间(4.30个月)(P<0.05);针对骨转移性前列腺癌患者,观察组的无CRPC发生中位时间(22.35个月)和中位PSADT时间(4.50个月)明显长于对照组的无CRPC发生中位时间(16.05个月)和中位PSADT时间(2.60个月)(P<0.05),两组治疗后PSA最低值差异无统计学意义。结论二甲双胍可明显延缓局限性前列腺癌根治术术后生化复发的发生,同时对于转移性前列腺癌可延缓CRPC发生。Objective To investigate the effects of preoperative use of metformin on the biochemical recurrence(BR)in the patients with localized prostate cancer after radical prostatectomy(RP)and on the occurrence of castration resistance in patients with bone metastasis after RP.Methods A retrospective analysis was performed on 192 patients diagnosed with localized prostate cancer and undergoing RP in our hospital from January 2008 to April 2020,including 31 cases of postoperative BR and 161 cases of bone metastatic prostate cancer.The patients were further divided into observation group(metformin with/without androgen deprivation therapy)and control group(no treatment/androgen deprivation therapy alone),based on whether they were preoperatively treated with metformin or not.The baseline characteristics of the 2 groups were collected and compared,including age,initial prostate specific antigen(PSA)level,PSA level at BR,pathological T stage,and Gleason score.The time to BR or to progression to castration-resistant prostate cancer(CRPC),PSA doubling time(PSADT),and PSA minimum were calculated and analyzed between the 2 groups.Results For the postoperative BR patients,the median time to BR(22.73 vs 10.73 months,P<0.05)and mean PSADT(4.69 vs 4.30 months,P<0.05)were significantly longer in the observation group than the control group.For the patients with bone metastatic prostate cancer,the observation group had obviously longer median time to CRPC(22.35 vs 16.05 months,P<0.05)and median PSADT(4.50 vs 2.60 months,P<0.05)when compared with the control group.But no such difference was seen in PSA minimum after treatment between them.Conclusion Metformin can effectively delay the progression of localized prostate cancer to BR after RP,and the progression of bone metastatic prostate cancer to CRPC.

关 键 词：二甲双胍 前列腺癌 生化复发 骨转移 

分 类 号：R737.25[医药卫生—肿瘤] R969.4[医药卫生—临床医学]