二甲双胍对不同亚型乳腺癌伴2型糖尿病患者预后影响的研究

doi:10.11904/j.issn.1002-3070.2022.06.008

实用肿瘤学杂志 ›› 2022, Vol. 36 ›› Issue (6): 531-537.doi: 10.11904/j.issn.1002-3070.2022.06.008

二甲双胍对不同亚型乳腺癌伴2型糖尿病患者预后影响的研究

教冲¹, 史雨鑫², 徐浩译¹, 马斌林¹, 董朝¹

1.新疆医科大学附属肿瘤医院乳腺甲状腺外科(乌鲁木齐 830011);
2.新疆医科大学附属肿瘤医院急诊科

收稿日期:2022-07-27 修回日期:2022-10-18 出版日期:2022-12-28 发布日期:2023-01-06
通讯作者: 董朝,E-mail:626195834@qq.com
作者简介:教冲,男,(1996-),硕士研究生,从事乳腺甲状腺肿瘤方向的研究
基金资助:
省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(编号:SKL-HIDCA2022-JZ2)

Study of the effect of metformin on prognosis of different subtypes of breast cancer patients with type 2 diabetes mellitus

JIAO Chong¹, SHI Yuxin², XU Haoyi¹, MA Binlin¹, DONG Chao¹

1. Department of Breast and Thyroid Surgery,The Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China;
2. Department of Emergency,The Affiliated Tumor Hospital of Xinjiang Medical University

Received:2022-07-27 Revised:2022-10-18 Online:2022-12-28 Published:2023-01-06

摘要/Abstract

摘要： 目的探究二甲双胍对不同亚型乳腺癌伴2型糖尿病患者预后影响。方法选取2000年1月—2019年12月在新疆医科大学附属肿瘤医院收治的乳腺癌伴2型糖尿病患者为糖尿病组(335例),随机选取同期就诊的乳腺癌非糖尿病患者为非糖尿病组(181例),比较两组患者临床病理特征。并根据糖尿病组是否口服二甲双胍将患者分为二甲双胍组(169例)与非二甲双胍组(166例),应用Kaplan-Meier法比较各组中不同亚型的乳腺癌患者的无病生存期(Disease free survival,DFS)及总生存期(Overall survial,OS)。使用单因素和多因素Cox回归模型分析临床病理特征与预后的相关性。结果糖尿病组患者较非糖尿病组确诊年龄更大,绝经后患者比例更高(P＜0.001)。Cox回归分析显示肿瘤大小、淋巴结转移、Ki67与患者OS和DFS有关,绝经状态为影响DFS的独立因素。生存分析显示非二甲双胍组1年、3年、5年、10年无病生存率和总生存率分别为91.5%、83.3%、81.1%、64.3%和97%、88.9%、85.1%、72.1%。明显低于二甲双胍组与非糖尿病组,差异均有统计学意义(P＜0.05)。516例乳腺癌患者中,Luminal型乳腺癌、HER2阳性乳腺癌、三阴性乳腺癌分别为299例、141例、76例。在Luminal型乳腺癌中,三组患者OS和DFS曲线比较,差异均无统计学意义(P＞0.05);在HER2阳性乳腺癌中,二甲双胍组与非糖尿病组OS与DFS均高于非二甲双胍组患者(P＜0.05);在三阴性乳腺癌中,二甲双胍组DFS明显优于非二甲双胍组(P＜0.05)。结论二甲双胍可以显著改善三阴性、HER2阳性乳腺癌伴2型糖尿病患者的预后。

关键词: 乳腺癌, 二甲双胍, 2型糖尿病, 预后分析

Abstract: Objective The aim of this study was to explore the effect of different molecular types of breast cancer with type 2diabetes.Methods The breast cancer patients with type 2 diabetes admitted to the Affiliated Cancer Hospital of Xinjiang Medical University from January 2000 to December 2019 were retrospectively analyzed as the diabetes group(335 cases),and the non-diabetic patients with breast cancer who visited at the same time were randomly selected as the non-diabetic group(181 cases),the clinicopathologic features of the two groups were compared.The patients were divided into the metformin group(169 cases)and non-metformin group(166 cases)according to whether the diabetic group took metformin orally or not.The Kaplan-Meier method was applied to compare the disease-free survival(DFS)and overall survival(OS)of breast cancer patients with different molecular types.Univariate and multivariate Cox regression models were used to analyze the correlation between clinicopathological features and prognosis.Results The patients in the diabetes group were older than those in the non-diabetes group,and the proportion of postmenopausal patients was higher(P＜0.001).Cox regression analysis showed that tumor size,lymph node metastasis and Ki67 were related to OS and DFS,and menopausal status was an independent factor affecting DFS.Survival analysis showed that the 1-year,3-year,5-year and 10-year disease-free survival and total survival rate were 91.5%,83.3%,81.1%,64.3% and 97%,88.9%,85.1%,72.1% in the non-metformin group,respectively.It was significantly lower than that of metformin group and non-diabetic group(P＜0.05).In 516 cases of breast cancer,299 cases of luminal type breast cancer,141 cases were HER2 positive breast cancer,and 76 cases were triple negative breast cancer.In luminal breast cancer,there was no significant difference in OS and DFS curves among the three groups(P＞0.05);In HER2 positive breast cancer,OS and DFS in the metformin group and non-diabetes group were higher than those the non-metformin group(P＜0.05);In triple-negative breast cancer,DFS in the metformin group was significantly better than in the non-metformin group(P＜0.05).Conclusion Metformin can significantly improve the prognosis of triple-negative,HER2 positive breast cancer patients with type 2 diabetes.

Key words: Breast cancer, Metformin, Type 2 diabetes, Prognostic analysis

中图分类号:

R737.9

教冲, 史雨鑫, 徐浩译, 马斌林, 董朝. 二甲双胍对不同亚型乳腺癌伴2型糖尿病患者预后影响的研究[J]. 实用肿瘤学杂志, 2022, 36(6): 531-537.

JIAO Chong, SHI Yuxin, XU Haoyi, MA Binlin, DONG Chao. Study of the effect of metformin on prognosis of different subtypes of breast cancer patients with type 2 diabetes mellitus[J]. Journal of Practical Oncology, 2022, 36(6): 531-537.

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二甲双胍对不同亚型乳腺癌伴2型糖尿病患者预后影响的研究

Study of the effect of metformin on prognosis of different subtypes of breast cancer patients with type 2 diabetes mellitus

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