Pena C M, Rice T W, Ahmad M, Medendorp S V
Department of Pulmonary Medicine, Cleveland Clinic Foundation 44195.
Chest. 1992 Jul;102(1):84-8. doi: 10.1378/chest.102.1.84.
Perioperative blood transfusions (BT) have been reported to reduce survival in patients undergoing curative resection of lung cancers. It is postulated that a state of BT-mediated immunosuppression favors the proliferation of tumor cells not resected during surgery. To evaluate this hypothesis and to determine factors influencing the administration of BT, we retrospectively studied the charts of 127 patients who underwent surgery for stage I and II non-small-cell carcinoma. Thirty (23.6 percent) patients received BT and 97 (76.4 percent) did not. Sex, age, race, smoking history, size and stage of the tumor, histology, extent of resection and preoperative hemoglobin values were analyzed. Only age (p = 0.01) and preoperative hemoglobin values (p less than 0.01) were related to transfusion status. Neither survival nor event-free survival differed significantly between the two groups (p = 0.29 and 0.26 respectively). Our results do not support the hypothesis that perioperative BTs have a significant detrimental effect on survival. A prospective study could clarify this controversial issue; however, such a study would be complex considering the multiple variables that affect survival in patients with non-small-cell lung cancers.
据报道，围手术期输血（BT）会降低接受肺癌根治性切除术患者的生存率。据推测，BT介导的免疫抑制状态有利于手术中未切除的肿瘤细胞增殖。为了评估这一假设并确定影响BT使用的因素，我们回顾性研究了127例接受I期和II期非小细胞癌手术患者的病历。30例（23.6%）患者接受了BT，97例（76.4%）未接受。分析了性别、年龄、种族、吸烟史、肿瘤大小和分期、组织学、切除范围和术前血红蛋白值。只有年龄（p = 0.01）和术前血红蛋白值（p < 0.01）与输血状态相关。两组之间的生存率和无事件生存率均无显著差异（分别为p = 0.29和0.26）。我们的结果不支持围手术期BT对生存率有显著不利影响这一假设。一项前瞻性研究可能会阐明这个有争议的问题；然而，考虑到影响非小细胞肺癌患者生存的多个变量，这样的研究将很复杂。
