血红蛋白水平与围手术期输血对结肠癌患者预后的影响

Effects of hemoglobin level and perioperative blood transfusion on the prognosis of patients with colon cancer

目的:本研究旨在探讨血红蛋白水平与围手术期输血对结肠癌患者预后的影响。方法:选择2008年10月至2010年12月在我院诊治的210例结肠癌患者作为研究对象,根据围手术期输血情况分为A组(输血量≥5 U)、B组(输血量<5 U)和C组(未输血)。所有患者均行结肠癌D2根治术,根据术前血红蛋白(hemoglobin,Hb)水平将患者分为严重贫血组(<6 g/dl)和非严重贫血组(≥6 g/dl),并对患者进行术后随访。结果:围手术期输血量与患者年龄、术前Hb水平、TNM分期、肿瘤直径和浸润深度等有关(均P<0.05)。单因素生存分析结果显示,年龄、围手术期输血量、TNM分期、肿瘤直径、组织分化程度、浸润深度与结肠癌患者预后相关(均P<0.05);年龄越大、围手术期输血量越多、TNM分期越晚、肿瘤直径越大、组织分化程度越低、浸润深度越深,则结肠癌患者无病生存期越短;多因素生存分析结果表明,围手术期输血量、肿瘤直径及浸润深度是结肠癌患者预后的独立危险因素(均P<0.05)。结论:围手术期输血与结肠癌患者预后不良密切相关,围手术期输血量越多,结肠癌患者预后效果更差,而术前Hb水平与结肠癌患者预后无明显关系。

Objective：To explore the effects of hemoglobin （Hb） level and perioperative blood transfusion （PBT） on the prognosis of patients with colon cancer.Methods：Between October 2008 and December 2010,a total of 210 patients diagnosed with colon cancer were enrolled in this study and were assigned into group A （PBT≥5 U）,group B （PBT 〈5 U） and group C （no PBT）.All patients received radical surgery with D2.Based on preoperative Hb level,these patients were divided into the severe aplastic anemia and non-severe aplastic anemia groups.A follow-up was performed after the surgery.Results：The lower preoperative Hb,age,more advance tumor node metastasis （TNM） staging,larger tumor diameter,deeper invasion and larger PBT were observed in older colon cancer patients （all P〈0.05）.Age,PBT,TNM staging,maximum tumor diameter,degree of differentiation and invasion were correlated with the prognosis of patients with colon cancer （all P〈0.05）.The PBT,tumor diameter,degree of invasion were the independent risk factors for the prognosis of colon cancer patients （all P〈0.05）.Conclusion：These findings indicated that PBT may be positively correlated with poor prognosis of colon cancer patients.However,there was no association between preoperative Hb level and the prognosis of patients with colon cancer.