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We read with interest the work by Chen et al 1 who reported the decreased risk for developing hepatocellular carcinoma (HCC) in patients treated with metformin in a dose-dependent and time-dependent manner. Indeed, the metabolic syndrome (MS) is becoming one of the leading risk factors for liver carcinogenesis, mainly through the presence of diabetes.2 ,3 In addition to clinical data confirming previous studies,4 Chen et al 1 were the first to highlight experimental antitumoral effects of metformin both on hepatoma cell lines and on murine models through cell-cycle arrest via AMPK activation. However, whether these results are transposable in a clinical setting of HCC occurring in the specific context of MS has to date remained uncertain.
To address this issue, we analysed a series of eight surgically resected HCC samples obtained from diabetic patients with MS preoperatively receiving (n=4) or not metformin (n=4) for antidiabetic purpose. Their clinicopathological characteristics …
FC and MM contributed equally.
Acknowledgements The authors would like to thank Professor Esteban Cvitkovic for his precious scientific advice, Dr Maude Le Gall for her help in the design of in vivo experiments and Réseau CRB foie, Tumorothèque Pathology Department, Hôpital Beaujon.
Contributors FC, MM and SL: selection of patient and WB analysis. MA: slides scanning and morphometry. PER, OS, ER and PB: patient recruitment and manuscript revision. VP: study design and writing.
Funding We gratefully acknowledge the financial support of the ‘Fondation Nelia et Amadeo Barletta’. François Cauchy also received a research grant from the ‘Association Benoit Malassagne’.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Institutional approval (local ethic committee).
Provenance and peer review Not commissioned; internally peer reviewed.