Genetet B
Laboratoire d'Immunologie, Faculté de Médecine, Rennes.
Presse Med. 1991;20(27):1275-80.
It has been known since 1974 that blood transfusion can depress the immune system, which proved to be a benefit for future renal transplant recipients since transplants were found to be better tolerated after one or several pre-transplantation transfusions. Hence the idea that the immunodepression thus obtained could have deleterious effects on cancer patients operated upon and receiving a blood transfusion during surgery. The first retrospective study, carried out in 1982, showed that among patients with cancer of the colon 84 percent of those who had not been perfused and only 51 percent of those who had been perfused were alive and without recurrence at 5 years. Since this study, numerous reports have been published with conflicting results in patients with cancer of the colon and rectum, as well as uterine cervix, kidney, lung, breast, vulva, stomach, soft tissues and the E.N.T. region cancers. Several hypotheses have been formulated to explain the immunosuppression, ranging from the action of "substances" in the plasma-solution sampling mixe to disorders in eicosanoids metabolism induced by blood perfusion. Today, no firm and definite conclusion can be drawn from these reports, but labile components of blood must always be used with caution.
自1974年以来，人们就知道输血会抑制免疫系统，这对未来的肾移植受者来说被证明是有益的，因为发现经过一次或几次移植前输血后，移植器官的耐受性更好。因此，有人认为这样获得的免疫抑制可能会对手术中接受输血的癌症患者产生有害影响。1982年进行的第一项回顾性研究表明，在结肠癌患者中，未接受输血的患者5年后仍存活且无复发的比例为84%，而接受输血的患者这一比例仅为51%。自这项研究以来，关于结肠癌、直肠癌以及子宫颈癌、肾癌、肺癌、乳腺癌、外阴癌、胃癌、软组织癌和耳鼻喉区域癌症患者的大量报告相继发表，结果相互矛盾。人们提出了几种假说来解释免疫抑制，从血浆溶液采样混合物中“物质”的作用到输血引起的类花生酸代谢紊乱不等。如今，从这些报告中无法得出确凿无疑的结论，但血液中的不稳定成分必须始终谨慎使用。
