Weiden P L, Bean M A, Schultz P
Cancer. 1987 Aug 15;60(4):870-4. doi: 10.1002/1097-0142(19870815)60:4<870::aid-cncr2820600425>3.0.co;2-0.
An adverse relationship between perioperative blood transfusions and the risk of subsequent recurrence of cancer was reported recently. We reviewed retrospectively the records of 171 patients who received initial therapy for colorectal adenocarcinoma from 1977 to 1979 at the Virginia Mason Medical Center. One hundred three patients (60%) received transfusions within 1 month of surgery and 37 patients (22%) developed recurrent cancer. No overall relationship between transfusion status (yes or no) and tumor recurrence or patient survival was found, although among subsets of patients (those with colon cancer or Dukes' Stage C2 disease), patients who had received transfusions were less likely to develop recurrent cancer than patients who had not (P = 0.01). No effect of transfusion on patient survival was found, even after consideration of potential confounding variables. The conflicting data regarding blood transfusion and cancer recurrence are reviewed, but it would appear to be premature to alter radically current blood transfusion practices based on the possibility that transfusion may adversely influence the risk of cancer recurrence.
最近有报告称围手术期输血与后续癌症复发风险之间存在不良关系。我们回顾性地查阅了1977年至1979年在弗吉尼亚梅森医疗中心接受结直肠腺癌初始治疗的171例患者的记录。103例患者(60%)在手术1个月内接受了输血,37例患者(22%)出现了癌症复发。尽管在部分患者亚组(结肠癌患者或杜克分期C2期疾病患者)中,接受输血的患者比未接受输血的患者发生癌症复发的可能性更小(P = 0.01),但未发现输血状态(是或否)与肿瘤复发或患者生存率之间存在总体关系。即使在考虑了潜在的混杂变量后,也未发现输血对患者生存率有影响。我们对关于输血与癌症复发的相互矛盾的数据进行了综述,但基于输血可能会对癌症复发风险产生不利影响这一可能性而从根本上改变当前的输血做法,似乎还为时过早。