![]()
糖尿病与乳腺癌风险增加相关，但是糖尿病对乳腺癌女性预后影响的研究结果不一。
2016年12月，美国巴尔的摩《医学》正式发表重庆医科大学附属第一医院、川北医学院附属医院赵小波和任国胜的系统回顾与荟萃分析报告，调查先前存在糖尿病对乳腺癌女性预后（总生存、无病生存、无复发生存）的影响。
作者检索了Embase和PubMed数据库截至2016年6月评定糖尿病对乳腺癌女性预后影响的队列或病例对照研究，使用总生存、无病生存、无复发生存的汇总多变量校正风险比及其95%置信区间分析糖尿病对乳腺癌患者预后的影响。
结果发现，包括48315例乳腺癌女性的17项研究符合预定入选标准。荟萃分析显示，有糖尿病的乳腺癌患者与无糖尿病的乳腺癌患者相比，总生存、无病生存的汇总校正风险比分别为1.51、1.28（95%置信区间分别为：1.34～1.70、1.09～1.50），无复发生存无显著差异（风险比：1.42，95%置信区间：0.90～2.23）。
本荟萃分析表明，先前存在糖尿病与女性乳腺癌患者总生存和无病生存不佳有独立相关性。然而，糖尿病对无复发生存的影响应被进一步验证。有必要开展更多前瞻研究，调查使用抗高血糖药物适当控制血糖是否可以改善糖尿病女性乳腺癌患者的预后。
Medicine (Baltimore). 2016 Dec;95(49):e5602.
Diabetes mellitus and prognosis in women with breast cancer: A systematic review and meta-analysis.
Zhao XB, Ren GS.
The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
BACKGROUND: Diabetes mellitus is associated with an increased risk of breast cancer, but studies of the effects of diabetes on the prognosis of women with breast cancer have yielded inconsistent findings. The present meta-analysis aimed to investigate the impact of preexisting diabetes on the prognosis in terms of overall survival (OS), disease-free survival (DFS), and relapse-free period (RFP) in women with breast cancer.
METHODS: We searched the Embase and PubMed databases until June 2016 for cohort or case-control studies assessing the impact of diabetes on the prognosis of women with breast cancer. The pooled multivariate adjusted hazard ratio (HR) and their 95% confidence intervals (CIs) for OS, DFS, and RFP were used to analyze the impact of diabetes on the prognosis of breast cancer patients.
RESULTS: Seventeen studies involving 48,315 women with breast cancer met our predefined inclusion criteria. Meta-analysis showed that the pooled adjusted HR was 1.51 (95% CI 1.34-1.70) for OS and 1.28 (95% CI 1.09-1.50) for DFS in breast cancer patients with diabetes compared to those without diabetes. However, RFP did not differ significantly between patients with and without diabetes (HR 1.42; 95% CI 0.90-2.23).
CONCLUSIONS: The present meta-analysis suggests that preexisting diabetes is independently associated with poor OS and DFS in female breast cancer patients. However, the impact of diabetes on RFP should be further verified. More prospective studies are warranted to investigate whether appropriate glycemic control with modification of antihyperglycemic agents can improve the prognosis of female breast cancer patients with diabetes.
PMID: 27930583
DOI: 10.1097/MD.0000000000005602
![]()
![]()
![]()
![]()
![]()
![]()
![]()
