本文選題：頭頸癌 + 鱗狀細(xì)胞癌��； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過系統(tǒng)回顧的方法,對(duì)既往研究進(jìn)行總結(jié),評(píng)估二甲雙胍對(duì)頭頸鱗癌的抗腫瘤作用,根據(jù)系統(tǒng)評(píng)價(jià)的結(jié)果,為二甲雙胍未來應(yīng)用于頭頸鱗癌的治療中提供循證醫(yī)學(xué)證據(jù)。方法:通過PICO原則預(yù)先制定檢索策略,檢索中文數(shù)據(jù)庫:中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(Chinese Biomedical Literature Database,CBM),英文數(shù)據(jù)庫:Cochrane Library,Pubmed,Embase。檢索國(guó)內(nèi)外二甲雙胍與頭頸鱗癌相關(guān)的所有文獻(xiàn),嚴(yán)格按照納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)對(duì)檢索結(jié)果進(jìn)行篩選,使用Cochrane協(xié)作網(wǎng)偏倚風(fēng)險(xiǎn)評(píng)估工具對(duì)納入文獻(xiàn)進(jìn)行方法學(xué)質(zhì)量評(píng)價(jià)并提取納入文獻(xiàn)的基本信息(按預(yù)提表格,對(duì)納入文獻(xiàn)進(jìn)行信息提取),并對(duì)納入文獻(xiàn)進(jìn)行結(jié)果的分析與討論。結(jié)果:通過對(duì)檢索文獻(xiàn)進(jìn)行篩選后,最終符合納排標(biāo)準(zhǔn)的文獻(xiàn)共29篇,包含臨床研究8篇,基礎(chǔ)研究22篇(其中一篇既有基礎(chǔ)研究又有臨床研究),由于所納入文獻(xiàn)的同質(zhì)性較差不符合Meta分析數(shù)據(jù)合并的條件,因而本次研究只采用了定性的系統(tǒng)綜述分析方法,分為兩部分:1二甲雙胍對(duì)頭頸鱗癌的臨床相關(guān)研究,共納入8篇文章,包含回顧隊(duì)列研究6篇,病例對(duì)照研究2篇。結(jié)果顯示:在頭頸鱗癌患者中應(yīng)用二甲雙胍可以減少腫瘤的局部復(fù)發(fā)和轉(zhuǎn)移,改善患者整體生存率和無病生存率;在糖尿病患者中應(yīng)用二甲雙胍比不應(yīng)用二甲雙胍具有較低的頭頸鱗癌發(fā)病率。2二甲雙胍對(duì)頭頸鱗癌的基礎(chǔ)相關(guān)研究,共納入22篇文章,包含體外細(xì)胞試驗(yàn)和(或)裸鼠移植瘤模型試驗(yàn)。這些研究結(jié)果表明二甲雙胍單用或者聯(lián)合其他治療對(duì)頭頸鱗癌細(xì)胞系具有顯著的抗腫瘤作用,包括:抑制癌細(xì)胞增殖,促進(jìn)癌細(xì)胞凋亡,誘導(dǎo)細(xì)胞周期G0/G1期阻滯以及調(diào)節(jié)腫瘤相關(guān)信號(hào)通路基因、蛋白的表達(dá)。雖然相關(guān)研究非常有限,但是,目前的可利用的證據(jù)顯示二甲雙胍對(duì)頭頸鱗癌具有潛在的影響。證實(shí)了二甲雙胍在細(xì)胞及移植瘤模型中潛在的抗腫瘤作用,并在一定程度上揭示了相關(guān)抗腫瘤生物機(jī)制。結(jié)論:本篇系統(tǒng)綜述通過回顧性方式收集相關(guān)研究,從臨床以及基礎(chǔ)方面闡述了二甲雙胍對(duì)頭頸鱗癌的預(yù)防和治療作用,提示二甲雙胍具有較好的臨床應(yīng)用前景。為將二甲雙胍應(yīng)用于臨床抗頭頸鱗癌治療中提供了可行性依據(jù)。雖然只有很少的相關(guān)研究,但目前可利用的證據(jù)已經(jīng)表明二甲雙胍對(duì)頭頸鱗癌的作用是引人矚目的。
[Abstract]:Objective: to evaluate the antitumor effect of metformin on head and neck squamous cell carcinoma (SCC) by a systematic review of previous studies. To provide evidence-based medical evidence for metformin in the treatment of head and neck squamous cell carcinoma. Methods: according to the PICO principle, Chinese Biomedical Literature database was used to search the Chinese Biomedical Literature database, and the Chinese Biomedical Literature database was used to search the Chinese Biomedical Literature database, and the English database:: Cochrane Library Pubmedmeda Embase.Methods: the Chinese biomedical literature database was used to search the Chinese Biomedical Literature database. All literatures about metformin associated with head and neck squamous cell carcinoma were searched, and the retrieval results were screened according to inclusion criteria and exclusion criteria. This paper uses the Cochrane cooperative network bias risk assessment tool to evaluate the methodological quality of the included literature and extract the basic information of the inclusion document (according to the advance table, extract the information of the inclusion document, and analyze and discuss the results of the inclusion document. Results: there were 29 articles, including 8 articles of clinical study, which met the standard of nano row after screening of the searched literature. There are 22 articles of basic research (one of which has both basic and clinical studies. Because the poor homogeneity of the included literature does not conform to the condition of combining Meta analysis data, this study only adopts qualitative systematic review analysis method. This study was divided into two parts: 1: 1 metformin for head and neck squamous cell carcinoma, including 8 articles, including 6 retrospective cohort studies and 2 case-control studies. The results showed that metformin could reduce the local recurrence and metastasis and improve the overall and disease-free survival rate in patients with head and neck squamous cell carcinoma. Metformin has a lower incidence of head and neck squamous cell carcinoma than no metformin in diabetic patients. Contains in vitro cell tests and / or nude mouse tumor transplantation model tests. These results suggest that metformin alone or in combination with other treatments has significant antitumor effects on head and neck squamous cell carcinoma cell lines, including inhibition of cancer cell proliferation and promotion of cancer cell apoptosis. Induces cell cycle G0/G1 arrest and regulates the expression of tumor related signal pathway genes and proteins. Although studies have been limited, available evidence suggests that metformin has a potential impact on head and neck squamous cell carcinoma. The potential antitumor effects of metformin in cell and transplanted tumor models were confirmed, and the related biological mechanisms of antitumor were revealed to some extent. Conclusion: this review systematically reviews the clinical and basic effects of metformin on the prevention and treatment of head and neck squamous cell carcinoma, indicating that metformin has a better clinical application prospect. It provides a feasible basis for the application of metformin in the treatment of head and neck squamous cell carcinoma. Although there are few studies available, the evidence available has shown that metformin has a remarkable effect on squamous cell carcinoma of the head and neck.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R739.91

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