Role Of Metformin In Prevention And Treatment Of Primary Carcinoma Of The Liver

Objective:To investigate the effects of metformin on preventing primary carcinoma of the liver(PCL)in patients with type 2 diabetes mellitus(T2DM)and affecting the prognosis.Methods:3124 patients admitted into Infectious Disease Department of Shandong Provincial Hospital from January 1,2015 to January 1,2018 were recruited,including 332 T2DM patients with PCL,165 T2DM patients without PCL,1433 PCL patients without T2DM and 1194 patients without T2DM and PCL.332 T2DM patients with PCL were included in this retrospective study.The patients were divided into metformin group(n=48)and non-metformin group(n=284).Among 165 T2DM patients without PCL,71 took metformin for treatment,while 94 didn't take metformin.A series of clinical data were collected to analyze the effects of metformin on PCL in patients with T2DM.The data of 332 T2DM patients with PCL were put into the EXCEL and database was established.SPSS19.0 statistical software was used for statistical analysis of clinical data.Measured data were expressed as mean ± standard deviation(mean ± SD).The t-test was used for comparison between the two groups.Chi-square test was used for the count data.P<0.05 was considered statistically significant.Results:1.Among the 3124 patients admitted into Infectious Disease Department of Shandong Provincial Hospital from January 1,2015 to January 1,2018,the number of T2DM patients with primary carcinoma of the liver(n = 332)was higher than that of T2DM patients without primary carcinoma of the liver(n = 165).The number of primary carcinoma of the liver patients without T2DM(n=1433)was similar to that of patients without T2DM and primary carcinoma of the liver(n=1194).2.Among 332 T2DM patients with primary carcinoma of the liver,male patients were more than female patients.The average age was 60.38±8.55 years old.The age was ranged from 39 to 85 years old,and 92%of patients were over 50 years old.The major type of liver cancer was hepatocellular carcinoma,while the cholangiocarcinoma and mixed type were rare.A single-sample t-test was performed on clinical measuring data of T2DM patients with primary carcinoma of the liver.Higher levels of FPG,HbA1c,ALT,AST,TBIL,CEA,AFP,CA125,and CA199 were discovered(p>0.05).3.Among 332 T2DM patients with primary carcinoma of the liver,two independent sample t-tests were performed.It's found that the CA199 level in metformin group were significantly lower than that in non-metformin group(p<0.05).There were no statistic significances of other indicators between metformin group and non-metformin groups(p>0.05).4.Among 119 T2DM patients on metformin(TID,0.5g,P.O.)admitted into Infectious Disease Department of Shandong Provincial Hospital from January 1,2015 to January 1,2018,48 patients with primary carcinoma of the liver and 71 patients without primary carcinoma of the liver were included.Among 378T2DM patients without taking metformin,284 patients with primary carcinoma of the liver and 94 patients without primary carcinoma of the liver were included.According to the results of Chi-square test,it's shown that the incidence of primary carcinoma of the liver in metformin group was significantly lower than that in non-metformin group,which was statistically significant(p<0.05).5.Among 48 T2DM patients with primary carcinoma of the liver,the patients on metformin for less than one year accounted for 35.4%,the patients on metformin for one to two years accounted for 27.1%,the patients on metformin for two to three years accounted for 20.8%and the patients on metformin for more than four years accounted for 16.7%.6.Among 332 T2DM patients with primary carcinoma of the liver,a chi-square test was performed for distant metastasis of primary carcinoma of the liver in metformin group and non-metformin group.It's found that the incidence of distant metastasis of primary liver cancer in metformin group was significantly lower than that of non-metformin group(p<0.05).Conclusions:1.Among the 3124 patients admitted into Infectious Disease Department of Shandong Provincial Hospital from January 1,2015 to January 1,2018,66.80%of 497 patients with T2DM were primary carcinoma of the liver;54.55%of 2697 patients without T2DM were diagnosed primary carcinoma of the liver,suggesting that T2DM may increase the risk of primary carcinoma of the liver.2.Among T2DM patients with chronic liver diseases,the incidence of primary carcinoma of the liver in metformin group was lower than that of non-metformin group,suggesting that metformin may have a preventive effect on primary carcinoma of the liver in T2DM patients.3.Among T2DM patients with primary carcinoma of the liver,the CA199 level in metformin group is significantly lower than that in non-metformin group.4.Among T2DM patients with primary carcinoma of the liver,the incidence of distant metastasis of primary carcinoma of the liver in metformin groups is significantly lower than that in non-metformin group.