Blumberg N, Agarwal M M, Chuang C
Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, New York.
Yale J Biol Med. 1988 Nov-Dec;61(6):493-500.
Some studies suggest that transfusion may be associated with an increased risk of recurrence of and death due to malignant human neoplasms. We examined retrospective data from patients with cervical cancer to see if any association between transfusion of blood at the time of initial treatment and the time interval to recurrence and death could be detected in this cancer. In 130 patients with cervical cancer, seen over a ten-year period at our institution, there was a trend toward earlier recurrence in transfused patients, but this trend did not achieve statistical significance. Death due to cervical cancer recurrence occurred after a median of Death due to cervical cancer recurrence occurred after a median of 12 months in the transfused patients and a median of 68 months in the non-transfused individuals, which was statistically significant. Transfused patients had, on average, more favorable prognostic factors than those not transfused, such as less advanced clinical stage of disease. Analysis using a proportional hazards risk model failed to demonstrate a significant association between transfusion and time to recurrence when other prognostic factors were considered, but a significant association between transfusion and time to cancer-related death (p less than 0.05) was found. While these results cannot be viewed as conclusive due to the small number and heterogeneity of the patients analyzed, our data support the possibility of an association between transfusion and cervical cancer survival. Further studies are warranted to confirm or refute this relationship.
一些研究表明,输血可能与人类恶性肿瘤复发风险增加及死亡有关。我们检查了宫颈癌患者的回顾性数据,以确定在这种癌症中,初始治疗时输血与复发时间间隔及死亡之间是否存在关联。在我们机构十年间诊治的130例宫颈癌患者中,输血患者有复发更早的趋势,但这一趋势未达到统计学显著性。输血患者因宫颈癌复发导致的死亡发生的中位时间为12个月,未输血患者为68个月,这具有统计学显著性。输血患者平均比未输血患者有更有利的预后因素,比如疾病的临床分期较晚。当考虑其他预后因素时,使用比例风险模型分析未能证明输血与复发时间之间存在显著关联,但发现输血与癌症相关死亡时间之间存在显著关联(p小于0.05)。虽然由于分析的患者数量少且存在异质性,这些结果不能被视为定论,但我们的数据支持输血与宫颈癌生存之间存在关联的可能性。有必要进行进一步研究以证实或反驳这种关系。