摘要人群的流行病学研究发现,糖尿病是甲状腺癌潜在的危险因素,而二甲双胍治疗的糖尿病患者甲状腺癌的风险降低.更多的研究表明,二甲双胍可降低患者血清促甲状腺激素水平,缩小甲状腺肿瘤体积,提高甲状腺癌完全缓解率和延长无进展生存期.二甲双胍对甲状腺癌的作用主要通过影响AMP活化蛋白激酶通路、哺乳动物雷帕霉素靶蛋白和胰岛素/胰岛素样生长因子通路,抑制甲状腺细胞和不同类型甲状腺癌细胞的生长,并协同增强化疗药物疗效,降低癌细胞的耐药性,有效抑制各类甲状腺癌细胞的增殖.目前,尚无直接证据支持二甲双胍可用于甲状腺癌术后促甲状腺激素抑制治疗.但基于较多的临床与基础研究,二甲双胍有可能在预防或治疗甲状腺癌中发挥一定作用.

abstractsEpidemiologic studies showed that diabetes was potential risk factor of thyroid cancer, while patients treated with metformin had a lower risk of thyroid cancer. Clinical trials have demonstrated that treatment with metformin was associated with decreased serum thyrotropin level, smaller tumor size, higher complete response rate and longer progression-free survival in patients with thyroid cancer. Metformin can inhibit the growth of thyroid cells and different types of thyroid cancer cells by affecting the adenosine 5'-monophosphate-activated protein kinase, mammalian target of rapamycin and insulin/insulin-like growth fac-tor pathways. Apart from this, metformin was found to amplify the effects of chemotherapeutic agents, poten-tiates the effect of doxorubicin in doxorubicin-resistant thyroid carcinoma cell line. So far there have not been enough direct evidence supporting that metformin can be used for thyroid stimulating hormone suppression therapy in postoperative hypothyroid patients. However, based on clinical and basic researches, metformin may play a promising role in prevention and treatment of thyroid cancer.