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[输血及血液衍生物对结直肠癌预后的影响]

[Effect of the transfusion of blood and hemoderivatives on the prognosis of colorectal cancer].

作者信息

Hermanek P, Guggenmoos-Holzmann I, Schricker K T, Resch T, Freudenberger K, Neidhardt P, Gall F P

机构信息

Chirurgische Klinik und Poliklinik, Universität Erlangen-Nürnberg.

出版信息

Langenbecks Arch Chir. 1989;374(2):118-24. doi: 10.1007/BF01261621.

Abstract

In recent years in the literature several investigators described a negative effect of perioperative transfusion of blood and hemoderivatives on the prognosis of malignant tumors. Concerning the patients with colorectal carcinoma operated between 1979 and 1983 at Erlangen University Hospital these results could be proven. We observed a significantly worse 5-year survival rate for patients who received perioperative blood transfusion. However, multivariant analysis in Cox-regression model revealed other factors like tumor stage and localisation responsible for the poorer prognosis. Therefore blood transfusion seems not to have any influence on the prognosis itself. Furthermore we observed a significantly poorer prognosis concerning patients who perioperatively received fresh frozen plasma (FFP). Surprisingly multivariant analysis showed that FFP substitution in contrast to blood transfusion has an own prognostic influence. This difference in prognosis cannot be explained by selection criteria. The mechanism of the negative influence of FFP on the prognosis of colorectal carcinoma remains unclear and is investigated currently in prospective studies.

摘要

近年来,文献中有多位研究者描述了围手术期输血及血液制品对恶性肿瘤预后的负面影响。对于1979年至1983年在埃尔朗根大学医院接受手术的结直肠癌患者,这些结果得到了证实。我们观察到围手术期接受输血的患者5年生存率明显更差。然而,Cox回归模型中的多变量分析显示,肿瘤分期和位置等其他因素才是导致预后较差的原因。因此,输血似乎本身对预后没有任何影响。此外,我们观察到围手术期接受新鲜冰冻血浆(FFP)的患者预后明显更差。令人惊讶的是,多变量分析表明,与输血相比,FFP替代有其自身的预后影响。这种预后差异无法用选择标准来解释。FFP对结直肠癌预后产生负面影响的机制尚不清楚,目前正在前瞻性研究中进行调查。

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