| Objective Meta-analysis was used to evaluate the prognostic effect and risk of metformin on patients with esophageal carcinoma combined with type 2 diabetes mellitus(T2DM),providing new evidence for the clinical treatment of metformin as an antitumor drug.Methods Formulate retrieval scheme,systematically search PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wan fang,and other databases by computer.This study included the relationship between metformin therapy and prognosis in patients with esophageal carcinoma complicated with T2DM from January 1980 to January 2022.All included studies were cohort studies.Quality evaluation and relevant data extraction were carried out for the included original studies,and the meta-analysis was performed using Revman5.4.1.Results A total of 80065 patients were included in 16 pieces of literature,including 38924 patients in the metformin treatment group and 41141 patients in the non-metformin treatment group.The results of the meta-analysis showed that the overall survival rate of patients with esophageal carcinoma combined with T2DM treated with metformin was significantly improved compared with those treated without metformin(HR=0.88,95%CI=0.80～0.98,P=0.01).The difference was statistically significant(P>0.05).Similarly,treatment with metformin in patients with T2DM reduces the incidence of esophageal cancer(HR=0.87,95%CI=0.77～0.99,P=0.03).Heterogeneity and sensitivity analysis was carried out for each study,and after excluding the studies that might cause heterogeneity,the research results were not changed.Conclusion Treatment with metformin prolongs survival and improves prognosis in patients with esophageal cancer associated with T2DM and is associated with the risk of esophageal cancer.It may be caused by the diversity of pathological types of esophageal cancer,the difference in pathogenesis,regional distribution,and the small sample size. |
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