Wu Gang, Zhang Dai-Yang, Duan Yu-Han, Zhang Ying-Qiong, Cui Xian-Nian, Luo Zheng
Department of Clinical Blood Transfusion, The Central Hospital of Hubei Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China (mainland).
Spinal Surgical Diagnosis and Treatment Center, The Central Hospital of Hubei Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China (mainland).
Med Sci Monit. 2017 May 23;23:2470-2478. doi: 10.12659/msm.900907.
BACKGROUND This study was designed to explore the correlations of hemoglobin level (Hb) and perioperative blood transfusion with the prognosis of gastric cancer (GC). MATERIAL AND METHODS Our study consisted of 210 patients with GC who all received a D2 radical operation. These patients were assigned into three groups: 68 cases in group A (blood transfusion >5 U); 59 cases in group B (blood transfusion <5 U); 83 cases in group C (without blood transfusion). A 5-year follow-up was conducted to evaluate the disease-free survival of the patients. Univariate analysis was performed to reveal the relationship between the indicators and the patients with GC. Kaplan-Meier method was employed to analyze the survival rate of patients, and Cox regression analysis was applied to determine the independent prognostic factors of GC. RESULTS The univariate analysis indicated that age, perioperative blood transfusion amount, TNM staging, maximal tumor diameter, differentiation degree and invasion degree were associated with the prognosis of GC. The Kaplan-Meier curve showed that the disease-free survival rate was declined in the patients who were older, those received more amount of blood transfusion, those in advanced TNM staging, those had larger tumor diameter, and those with decreased degree of differentiation and invasion. Cox regression analysis indicated that perioperative blood transfusion, maximal tumor diameter and invasion degree were the independent factors affecting disease-free survival of the GC. CONCLUSIONS Our study revealed that large amount of perioperative blood transfusion leads to poor prognosis of GC.
背景 本研究旨在探讨血红蛋白水平(Hb)和围手术期输血与胃癌(GC)预后的相关性。
材料与方法 我们的研究纳入了210例行D2根治术的GC患者。这些患者被分为三组:A组68例(输血>5 U);B组59例(输血<5 U);C组83例(未输血)。进行5年随访以评估患者的无病生存期。采用单因素分析揭示各项指标与GC患者之间的关系。采用Kaplan-Meier法分析患者生存率,应用Cox回归分析确定GC的独立预后因素。
结果 单因素分析表明,年龄、围手术期输血量、TNM分期、肿瘤最大直径、分化程度和浸润程度与GC预后相关。Kaplan-Meier曲线显示,年龄较大、输血量较多、TNM分期较晚、肿瘤直径较大、分化程度和浸润程度降低的患者无病生存率下降。Cox回归分析表明,围手术期输血、肿瘤最大直径和浸润程度是影响GC患者无病生存的独立因素。
结论 我们的研究表明,围手术期大量输血会导致GC预后不良。