二甲双胍已成为临床治疗2型糖尿病的一线口服降糖药，最新研究表明二甲双胍除了能通过改善胰岛素抵抗、抑制肝脏糖异生等参与调节血糖水平外，还能明显降低糖尿病患者中卵巢癌、肝癌、肺癌等多种癌症的发生率、复发率和死亡率。综述了二甲双胍能通过激活AMPK信号通路、诱导细胞周期停滞及细胞凋亡、抑制血管生成、抑制膀胱癌干细胞增殖、增强化疗药物等对膀胱癌细胞的疗效等多种分子机制产生抗膀胱癌的作用，展望了其成为新一代治疗膀胱癌药物的可能。

Currently, metformin has become a first-line oral hypoglycemic agent for the treatment of type 2 diabetes mellitus. The latest research shows that metformin can not only play a role in regulating blood glucose level by improving insulin resistance and inhibiting liver gluconeogenesis, but also significantly reduce the incidence, recurrence and mortality of many types of cancer, such as ovarian cancer, liver cancer, and lung cancer in diabetic patients. This paper summarizes that metformin can produce anti-bladder cancer effects by activating AMPK signaling pathway, inducing cell cycle arrest and apoptosis, inhibiting angiogenesis, inhibiting the proliferation of bladder cancer stem cells, and enhancing the efficacy of chemotherapy drugs on bladder cancer cells and provides the possibility of metformin as a new drugs for the treatment of bladder cancer.