围手术期输血对肾癌术后患者预后影响的Meta分析  

Effect of perioperative blood transfusion on the prognosis of postoperative patients with renal cell carcinoma:A Meta-analysis

作　　者：马金鹏 何康 邓姣 叶春伟[1] 邱学德[1] MA Jinpeng;HE Kang;DENG Jiao;YE Chunwei;QIU Xuede(Department of Urology,the Second Affiliated Hospital of Kunming Medical University,Yunnan Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院泌尿外科,云南昆明650101

出　　处：《现代肿瘤医学》2022年第7期1244-1248,共5页Journal of Modern Oncology

基　　金：国家自然科学基金(编号:82060533);昆明医科大学研究生基金项目(编号:2021S230)。

摘　　要：目的:系统评价围手术期输血(perioperative blood transfusion,PBT)对肾癌术后患者预后的影响。方法:检索从建库至2021年06月关于接受PBT的肾癌手术患者与未接受PBT患者对比分析的相关文献,检索数据库包括Pubmed、Embase、Cochrane library、中国生物医学文献数据库、中国知网、维普中文科技期刊数据库和万方中文数据库。对纳入的文献使用统计软件RevMan 5.4进行Meta分析。主要结局指标为无复发生存率(FRS)、总生存率(OS)和肿瘤特异性生存率(CSS)。结果:共纳入10篇回顾性研究,包含30199例肾癌手术患者,其中3845例患者行PBT治疗,26354例未行PBT治疗。结果显示围手术期输血增加总体死亡风险的相关性为36%[HR 1.36(1.26~1.47)],I^(2)为35%。围手术期输血后的肿瘤特异性生存率比不输血组低65%[HR 1.65(1.34~2.03)],I^(2)为58%。围手术期输血无复发生存率比不输血的要低55%[HR 1.55(1.29~1.88)],I^(2)为5%。结论:围手术期输血与降低无复发生存率、肿瘤特异性生存率和总生存率存在显著相关性。但仍需要设计一些设计良好的前瞻性随机对照试验提供高质量的证据进一步论证该问题。Objective:To systematically evaluate the effect of perioperative blood transfusion(PBT)on the prognosis of patients after renal cancer surgery.Method:From database establishment to June 2021,the relevant literatures on the comparative analysis of patients with renal cancer who received PBT and those who did not receive PBT were searched,including Pubmed,Embase,Cochranelibrary,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,VIP Chinese Science and Technology Journal Database and Wanfang Chinese Database.Meta-analysis was performed on the included articles using the statistical software RevMan 5.4.The primary outcome measures were recurrence-free survival(FRS),overall survival(OS),and tumor-specific survival(CSS).Results:A total of 10 retrospective studies were included,including 30199 patients undergoing renal cancer surgery,of which 3845 patients were treated with PBT and 26354 were not treated with PBT.The results showed an association of 36%[HR 1.36(1.26~1.47)]and I^(2) of 35% for perioperative blood transfusion to increase the overall risk of death.Tumor-specific survival after perioperative transfusion was 65% lower[HR 1.65(1.34~2.03)]and I^(2) of 58% than in the group without transfusion.Perioperative transfusion was associated with a 55%lower recurrence-free survival rate[HR 1.55(1.29~1.88)]and an I^(2) of 5% compared with no transfusion.Conclusion:Perio-perative blood transfusion was significantly associated with reduced recurrence-free survival,tumor-specific survival and overall survival.However,there is still a need to design some well-designed prospective randomized controlled trials to provide high-quality evidence to further argue this issue.

关 键 词：围手术期输血 肾癌手术 系统评价 META分析 

分 类 号：R737.11[医药卫生—肿瘤]