Meta Analysis Of The Effect Of Metformin On The Risk And Prognosis Of Ovarian Cancer In Patients With Type 2 Diabetes Mellitus

Objective:To collect original data on the risk of ovarian cancer and prognosis in patients with metformin and type 2 diabetes,and to use meta-analysis to evaluate the relationship between the use of metformin and the risk of ovarian cancer and prognosis in patients with type 2 diabetes,and use metformin for ovarian cancer.Prevention and treatment provide evidence-based medical evidence.Methods:Using computer retrieval PubMed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),a database of Wan fang,set the time as to December 31,2017,since the building of the Library,retrieval of metformin treatment in patients with type 2 diabetes mellitus treatment of the relationship between risk and prognosis of ovarian cancer before and after the study,and will conform to the standard of literature included.The intervention was interpreted with metformin and untreated metformin.The main outcome indicators of the observation were incidence(incidence),progression-free survival(PFS)and overall survival(OS),data extraction,and data analysis using STATA 13.0 statistical software.Results:The final inclusion of 10 articles,including 11 independent studies,and 6 cohort studies,3 case-control studies,2 randomized controlled studies,containing 565,237 patients.Cohort studies and case-control studies were carried out using the NOS scoring system.Randomized controlled trial were carried out using the Jadad quality scoring method.After evaluation,11 studies were all high-quality studies.The meta-analysis showed that the risk of developing ovarian cancer was lower who has been used metformin than in patients with type 2 diabetes who did not useing metformin.The difference was statistically significant(OR=0.54,95%CI:0.32 to 0.93,P=0.025).Overall survival and progression-free survival were comparable between metformin and non-metastatic ovarian cancer patients in type 2 diabetes.The increase was statistically significant(HR=0.56,95%CI:0.38-0.83,P=0.004),(HR=0.37,95%CI:0.27-0.51,P<0.001).There was a certain heterogeneity in the incidence group and the overall survival group after the effect amount was combined(Q test P<0.001;I~2=85.4%;Q test P<0.001,I~2=69.0%),and further sensitivity analysis was performed.Stabilization and exclusion of studies that may cause heterogeneity have no impact on the results of this study.The use of funnel plots for biased assessment of inclusion studies suggests that there is a certain bias in the publication.Conclusion:Metformin reduces the risk of ovarian cancer in patients with diabetes,and it also tends to prolong the survival of patients with diabetes mellitus.