Heal J M, Chuang C, Blumberg N
Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, New York 14642.
Am J Surg. 1988 Nov;156(5):374-80. doi: 10.1016/s0002-9610(88)80190-9.
This retrospective clinical study of patients with nonmetastatic prostate cancer demonstrates that patients transfused at the time of initial diagnosis or operation have a higher frequency of recurrence (54 percent) and death due to cancer (19 percent) than patients not receiving blood transfusions (recurrence rate 31 percent, p = 0.005; death rate 10 percent, p = 0.08). This difference is not explained by the transfused patients being older, having a less favorable clinical stage of disease, or less differentiated tumor histology. A multivariate analysis confirmed that the additional risk of dying from prostate cancer was 2.82-fold higher in transfused patients than in those not transfused. As in previous studies, the risk of recurrence may be greater in those receiving whole blood transfusions. Prospective studies of the association between perioperative blood transfusion and cancer recurrence are needed. For the present, prudent clinical practice should include avoidance of whole blood, fresh frozen plasma, and platelet transfusions and greater reliance on autologous blood transfusions.
这项针对非转移性前列腺癌患者的回顾性临床研究表明，与未接受输血的患者相比，在初次诊断或手术时接受输血的患者复发频率更高（54%），因癌症死亡的比例更高（19%）（未输血患者的复发率为31%，p = 0.005；死亡率为10%，p = 0.08）。这种差异不能用接受输血的患者年龄更大、疾病临床分期更不理想或肿瘤组织学分化程度更低来解释。多变量分析证实，接受输血的患者死于前列腺癌的额外风险比未输血患者高2.82倍。与之前的研究一样，接受全血输血的患者复发风险可能更高。需要对围手术期输血与癌症复发之间的关联进行前瞻性研究。目前，谨慎的临床实践应包括避免使用全血、新鲜冰冻血浆和血小板输血，并更多地依靠自体输血。
