Xu Dazhou, Fang Xinjian, Li Yi, Zhang Zhimei, Li Qiuling
Department of Gastroenterology, The First People's Hospital of Lianyungang, Lianyungang Hospital affiliated to Xuzhou Medical University, Lianyungang, Jiangsu 222000, China.
J BUON. 2018 May-Jun;23(3):672-677.
To demonstrate the potential significance of perioperative blood transfusion on the prognosis of gastric cancer.
Data from 234 patients who were subjected to radical gastrectomy in our hospital were obtained and retrospectively analyzed. Patients' age, gender, preoperative anemia, tumor size, location, invasion depth, lymph node metastasis, TNM stage, presence or absence of blood transfusion and blood transfusion volume were observed and analyzed.
The difference of tumor recurrence in patients whose blood transfusion volume was greater than 2U was significant (p<0.001). The tumor recurrence in patients whose blood transfusion was less than 2U was significantly shorter than in those whose transfusion volume was greater than 4U (p=0.03). The survival in the blood transfusion group was significantly lower in comparison with the nonblood transfusion group (p=0.002). The survival of transfusion group in TNM stage III and IV was significantly shorter than that in non-transfusion group (p=0.03). Statistical significance was found in survival between the transfusion group and non-transfusion group when the tumor size was less than 5 cm and greater than 5 cm (p=0.006, p=0.04, respectively).
Perioperative transfusion is one of the factors for predicting the prognosis of postoperative gastric cancer patients, and the larger the perioperative transfusion, the shorter the tumor recurrence, the worse the prognosis. Therefore, it is of great significance reducing the intraoperative blood loss and strict controlling blood transfusion indications.
探讨围手术期输血对胃癌预后的潜在意义。
获取我院234例行根治性胃切除术患者的数据并进行回顾性分析。观察并分析患者的年龄、性别、术前贫血情况、肿瘤大小、位置、浸润深度、淋巴结转移、TNM分期、是否输血及输血量。
输血量大于2U的患者肿瘤复发差异有统计学意义（p<0.001）。输血量小于2U的患者肿瘤复发明显短于输血量大于4U的患者（p=0.03）。输血组的生存率明显低于非输血组（p=0.002）。TNM分期为III期和IV期的输血组患者生存率明显短于非输血组（p=0.03）。肿瘤大小小于5cm和大于5cm时，输血组与非输血组的生存率差异有统计学意义（分别为p=0.006，p=0.04）。
围手术期输血是预测胃癌术后患者预后的因素之一，围手术期输血量越大，肿瘤复发越短，预后越差。因此，减少术中失血和严格控制输血指征具有重要意义。
