围手术期输血对肝细胞癌患者术后早期复发的影响

Effect of perioperative allogeneic red blood cells transfusion on early postoperative recurrence in patients with hepatocellular carcinoma

目的探讨肝切除术围手术期输同种异体红细胞对肝细胞癌(HCC)患者早期复发的影响。方法回顾性分析999例接受HCC根治性切除术的患者,按围手术期是否输同种异体红细胞,分为输红细胞组及未输红细胞组。运用倾向性评分匹配(PSM)均衡组间差异,采用Kaplan-Meier法比较两组患者早期复发(2年内)的差异,并通过多因素COX回归分析筛选影响HCC患者术后早期复发的独立风险因素。结果输红细胞组100例(10%),未输红细胞组899例。经过PSM,85对患者匹配成功,组间基线资料无明显差异。PSM前,输红细胞组早期无瘤生存率低于未输红细胞组(P<0.05)。PSM后,两组患者早期无瘤生存率的差异无统计学意义(P=0.346)。多因素分析显示围手术期输同种异体红细胞不是HCC患者术后早期复发的独立危险因素(P=0.153)。结论围手术期输同种异体红细胞对HCC患者术后早期复发无显著影响。

Objective To investigate the impact of perioperative allogeneic red blood cells transfusion on the early recurrence of patients with hepatocellular carcinoma(HCC)after liver resection.Methods Retrospective analysis was made on 999 patients who underwent surgical resection for HCC,and these patients were divided into two groups according to whether or not received perioperative allogeneic red blood cells transfusion.Differences between groups were balanced using propensity score matching(PSM).The Kaplan-Meier method was used for comparing the differences in early recurrence(within 2 years)between the two groups and the multivariate COX analysis regression was used to identify independent risk factors for early recurrence.Result There were 100 patients in red cell transfusion group and 899 patients in non-red cell transfusion group.After PSM,85 pairs of patients were successfully matched,and there was no significant difference in baseline data between groups.Before PSM,the early recurrence rate of the red blood cell group was significantly higher than that of the non-red blood cell group(P<0.05).However,there was no significant difference in early recurrence rates between the two groups after PSM(P=0.346).Multivariate analysis showed that perioperative allogeneic red blood cells transfusion was not an independent risk factor of early recurrence for patients with HCC after liver resection(P=0.153).Conclusion Perioperative allogeneic red blood cells transfusion has no impact on the early recurrence of patients with HCC after liver resection.