二甲双胍对头颈鳞癌的作用：系统评价

发布时间：2018-04-22 16:38

本文选题：头颈癌 + 鳞状细胞癌　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:通过系统回顾的方法,对既往研究进行总结,评估二甲双胍对头颈鳞癌的抗肿瘤作用,根据系统评价的结果,为二甲双胍未来应用于头颈鳞癌的治疗中提供循证医学证据。方法:通过PICO原则预先制定检索策略,检索中文数据库:中国生物医学文献数据库(Chinese Biomedical Literature Database,CBM),英文数据库:Cochrane Library,Pubmed,Embase。检索国内外二甲双胍与头颈鳞癌相关的所有文献,严格按照纳入标准及排除标准对检索结果进行筛选,使用Cochrane协作网偏倚风险评估工具对纳入文献进行方法学质量评价并提取纳入文献的基本信息(按预提表格,对纳入文献进行信息提取),并对纳入文献进行结果的分析与讨论。结果:通过对检索文献进行筛选后,最终符合纳排标准的文献共29篇,包含临床研究8篇,基础研究22篇(其中一篇既有基础研究又有临床研究),由于所纳入文献的同质性较差不符合Meta分析数据合并的条件,因而本次研究只采用了定性的系统综述分析方法,分为两部分:1二甲双胍对头颈鳞癌的临床相关研究,共纳入8篇文章,包含回顾队列研究6篇,病例对照研究2篇。结果显示:在头颈鳞癌患者中应用二甲双胍可以减少肿瘤的局部复发和转移,改善患者整体生存率和无病生存率;在糖尿病患者中应用二甲双胍比不应用二甲双胍具有较低的头颈鳞癌发病率。2二甲双胍对头颈鳞癌的基础相关研究,共纳入22篇文章,包含体外细胞试验和(或)裸鼠移植瘤模型试验。这些研究结果表明二甲双胍单用或者联合其他治疗对头颈鳞癌细胞系具有显著的抗肿瘤作用,包括:抑制癌细胞增殖,促进癌细胞凋亡,诱导细胞周期G0/G1期阻滞以及调节肿瘤相关信号通路基因、蛋白的表达。虽然相关研究非常有限,但是,目前的可利用的证据显示二甲双胍对头颈鳞癌具有潜在的影响。证实了二甲双胍在细胞及移植瘤模型中潜在的抗肿瘤作用,并在一定程度上揭示了相关抗肿瘤生物机制。结论:本篇系统综述通过回顾性方式收集相关研究,从临床以及基础方面阐述了二甲双胍对头颈鳞癌的预防和治疗作用,提示二甲双胍具有较好的临床应用前景。为将二甲双胍应用于临床抗头颈鳞癌治疗中提供了可行性依据。虽然只有很少的相关研究,但目前可利用的证据已经表明二甲双胍对头颈鳞癌的作用是引人瞩目的。
[Abstract]:Objective: to evaluate the antitumor effect of metformin on head and neck squamous cell carcinoma (SCC) by a systematic review of previous studies. To provide evidence-based medical evidence for metformin in the treatment of head and neck squamous cell carcinoma. Methods: according to the PICO principle, Chinese Biomedical Literature database was used to search the Chinese Biomedical Literature database, and the Chinese Biomedical Literature database was used to search the Chinese Biomedical Literature database, and the English database:: Cochrane Library Pubmedmeda Embase.Methods: the Chinese biomedical literature database was used to search the Chinese Biomedical Literature database. All literatures about metformin associated with head and neck squamous cell carcinoma were searched, and the retrieval results were screened according to inclusion criteria and exclusion criteria. This paper uses the Cochrane cooperative network bias risk assessment tool to evaluate the methodological quality of the included literature and extract the basic information of the inclusion document (according to the advance table, extract the information of the inclusion document, and analyze and discuss the results of the inclusion document. Results: there were 29 articles, including 8 articles of clinical study, which met the standard of nano row after screening of the searched literature. There are 22 articles of basic research (one of which has both basic and clinical studies. Because the poor homogeneity of the included literature does not conform to the condition of combining Meta analysis data, this study only adopts qualitative systematic review analysis method. This study was divided into two parts: 1: 1 metformin for head and neck squamous cell carcinoma, including 8 articles, including 6 retrospective cohort studies and 2 case-control studies. The results showed that metformin could reduce the local recurrence and metastasis and improve the overall and disease-free survival rate in patients with head and neck squamous cell carcinoma. Metformin has a lower incidence of head and neck squamous cell carcinoma than no metformin in diabetic patients. Contains in vitro cell tests and / or nude mouse tumor transplantation model tests. These results suggest that metformin alone or in combination with other treatments has significant antitumor effects on head and neck squamous cell carcinoma cell lines, including inhibition of cancer cell proliferation and promotion of cancer cell apoptosis. Induces cell cycle G0/G1 arrest and regulates the expression of tumor related signal pathway genes and proteins. Although studies have been limited, available evidence suggests that metformin has a potential impact on head and neck squamous cell carcinoma. The potential antitumor effects of metformin in cell and transplanted tumor models were confirmed, and the related biological mechanisms of antitumor were revealed to some extent. Conclusion: this review systematically reviews the clinical and basic effects of metformin on the prevention and treatment of head and neck squamous cell carcinoma, indicating that metformin has a better clinical application prospect. It provides a feasible basis for the application of metformin in the treatment of head and neck squamous cell carcinoma. Although there are few studies available, the evidence available has shown that metformin has a remarkable effect on squamous cell carcinoma of the head and neck.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.91

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