Meng Jin, Lu Xiao-Bo, Tang Yuan-Xin, Sun Gong-Ping, Li Xin, Yan Yi-Fei, Liang Gao-Feng, Ma Si-Ping, Li Xiao-Xia
Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University, Shenyang, China.
Asian Pac J Cancer Prev. 2013;14(1):347-50. doi: 10.7314/apjcp.2013.14.1.347.
The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year follow-up study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank =0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.
本研究的目的是确定异体红细胞输血是否具有有害作用，以及TNM II期结肠癌患者术前输血的风险因素可能有哪些。共选择了470例符合纳入标准的患者进行为期10年的随访研究。我们发现，未输血组和输血组在死亡率（P = 0.018）、局部复发（P = 0.000）和远处转移（P = 0.040）方面存在统计学意义。1至3单位输血组和超过3单位输血组之间的局部复发和远处转移没有显著差异。未输血组和1至3单位输血组之间的生存率没有差异（对数秩 = 0.031，P = 0.860）。发现输血患者不同输血量之间存在差异（78.77%对63.83%，P = 0.006）。同时，未输血组和超过3单位输血组之间的生存率存在显著差异（84.83%对63.83%，P = 0.002）。单因素分析显示以下3个变量与异体输血风险增加相关：术前癌胚抗原水平（P < 0.05）、肿瘤位置（P < 0.01）和肿瘤直径（P < 0.01）。多因素分析表明，肿瘤位置和肿瘤直径是围手术期输血需求的两个独立因素。因此，异体输血增加了II期结肠癌患者术后的肿瘤死亡率、局部复发和远处转移。术后肿瘤死亡率、局部复发和远处转移与输血量无关。输血量与生存率相关。肿瘤位置和肿瘤直径是输血的独立术前风险因素。
