PLA2G4A and neoplasm: These functions encompassed processes such as development, differentiation, apoptosis, and proliferation, elucidating the intricate connections between metformin, genes, and the pathogenesis of ESCC [67,68,69] In particular, metformin might activate the TMCO3 and PLA2G4A genes, which are tumor suppressor genes upregulated by miR-375 and have a tumor-suppressive function in themselves as an alternative substance to miR-375 [67].