Perioperative allogenenic blood transfusion is associated with worse clinical outcomes for hepatocellular carcinoma: a meta-analysis.
Perioperative allogenenic blood transfusion is associated with worse clinical outcomes for hepatocellular carcinoma: a meta-analysis.
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DOI：
10.1371/journal.pone.0064261
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zhang Y
中科院分区：
文献类型：
--
作者：
Liu L;Wang Z;Jiang S;Shao B;Liu J;Zhang S;Zhou Y;Zhou Y;Zhang Y
围手术期异体输血（ABT）对肝细胞癌（HCC）临床结局的影响是相互矛盾和不清楚的。本荟萃分析的目的是评价ABT和HCC临床结局之间的相关性。评价的结局包括全因死亡、肿瘤复发和术后并发症。通过MEDLINE检索识别出相关文章（截至2012年11月）。采用固定效应模型或随机效应模型进行Meta分析。研究异质性采用Q检验和I2检验。采用漏斗图、Egger检验和Begg检验评价发表偏倚。来自22项研究的5635例病例最终符合我们的纳入标准。Meta分析显示，与未行ABT的患者相比，行ABT的患者术后3年和5年全因死亡的风险增加（分别为：OR = 1.92，95%CI，1.61- 2.29，P <0.001; OR = 1.60，95%CI，1.47- 1.73，P <0.001）。 ABT组术后1、3、5年肿瘤复发的危险性明显高于对照组（OR分别为1.70、1.22、1.16、1.08、1.24，P<0.001）。 ABT组术后并发症发生率明显高于非ABT组（OR = 1.78，95% CI，1.34-2.37，P<0.001）。 当前荟萃分析的结果表明，ABT与接受手术的HCC患者的不良临床结局相关，包括死亡、复发和并发症增加。因此，如果可能，不应进行ABT。
The impact of perioperative allogenenic blood transfusion (ABT) on clinical outcomes for hepatocellular carcinoma (HCC) is conflicting and unclear. The aim of this meta-analysis is to evaluate the association between ABT and HCC clinical outcomes. Outcomes evaluated were all-cause death, tumor recurrence and postoperative complications. Relevant articles were identified through MEDLINE search (up to November 2012). Meta-analyses were performed by using the fixed or random effect models. Study heterogeneity was assessed by Q-test and I2 test. Publication bias was evaluated by funnel plots, Egger′s and Begg’s test. A total of 5635 cases from 22 studies finally met our inclusion criteria. Meta-analysis indicated HCC patients with ABT had an increased risk of all-cause death at 3 and 5 years after surgery (respectively: OR = 1.92, 95% CI, 1.61–2.29,P<0.001; OR = 1.60, 95% CI, 1.47–1.73,P<0.001 ) compared with those without ABT. The risk of tumor recurrence was significantly higher for ABT cases at 1, 3 and 5 years (respectively: OR = 1.70, 95% CI, 1.38–2.10, P<0.001; OR = 1.22, 95% CI, 1.08–1.38, P<0.001; OR = 1.16, 95% CI, 1.08–1.24, P<0.001). The HCC cases with ABT significantly increased postoperative complications occurrence compared with non-ABT cases (OR = 1.78,95% CI, 1.34–2.37, P<0.001). The findings from the current meta-analysis demonstrated that ABT was associated with adverse clinical outcomes for HCC patients undergoing surgery, including increased death, recurrence and complications. Therefore, ABT should not be performed if possible.
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