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Lung cancer is the leading cause of cancer-related deaths globally. Despite recent improvements in incidence and mortality rates, the prognosis of lung cancer remains dire.18F-FDG PET/CT plays a vital role in diagnosing, staging, and monitoring the therapeutic efficacy of lung cancer. However, the high glucose metabolism in inflammatory lesions, driven by macrophage activation, aggregation, and the release of inflammatory factors, is a primary source of false-positive results in FDG PET/CT oncology. This significantly diminishes the specificity and accuracy of PET/CT in diagnosing and staging lung cancer.Here we show FoxO1 plays a role in glucose metabolism in macrophages.We found that metformin regulated FoxO1 expression in macrophages, regulated the expression of inflammatory mediators and apoptosis of macrophages, thus reducing inflammatory glucose metabolism and improving the diagnostic accuracy of 18F-FDG PET/CT in lung cancer.We anticipate that our study could provide a credible approach to improve tumor diagnostic accuracy with PET/CT.

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Objective: Well-conducted meta-analyses (MAs) are considered as one of the best sources of clinical evidence for treatment decision. MA with methodological flaws may introduce bias and mislead evidence users. The aim of this study is to investigate the characteristics and methodological quality of MAs on diabetes mellitus (DM) treatments., Design: Systematic review., Methods: Cochrane Database of Systematic Review and Database of Abstract of Reviews of Effects were searched for relevant MAs. Assessing methodological quality of systematic reviews (AMSTAR) tool was used to evaluate the methodological quality of included MAs. Logistic regression analysis was used to identify association between characteristics of MA and AMSTAR results., Results: A total of 252 MAs including 4999 primary studies and 13,577,025 patients were included. Over half of the MAs (65.1%) only included type 2 DM patients and 160 MAs (63.5%) focused on pharmacological treatments. About 89.7% MAs performed comprehensive literature search and 89.3% provided characteristics of included studies. Included MAs generally had poor performance on the remaining AMSTAR items, especially in assessing publication bias (39.3%), providing lists of studies (19.0%) and declaring source of support comprehensively (7.5%). Only 62.7% MAs mentioned about harm of interventions. MAs with corresponding author from Asia performed less well in providing MA protocol than those from Europe., Conclusions: Methodological quality of MA on DM treatments was unsatisfactory. There is considerable room for improvement, especially in assessing publication bias, providing lists of studies and declaring source of support comprehensively. Also, there is an urgent need for MA authors to report treatment harm comprehensively., (© 2016 European Society of Endocrinology.)