Influence of Transfusion to the Growth of Cancer-Soluble MHC Class I

同种异体输血似乎会诱导受体的免疫调节，从而增加癌症复发的可能性。在本研究中，我们回顾性分析了接受食管切除术治疗胸段食管癌的患者，并比较了接受同种异体输血与接受自体输血的患者的结局。比较影响预后的临床病理因素及生存率和无病生存率。我们发现两组影响预后的临床病理因素相似;然而，接受自体血回输的患者明显具有生存优势。食管癌复发率或复发后的生存时间没有显著差异。另一方面，在接受自体血输注的患者中，复发前的无病生存期显著延长，多因素分析显示， 关于我们 自体输血是影响食管癌患者生存的独立预后因素。我们的临床研究结果表明，同种异体血液中存在的一种或多种未知介质可能抑制对食管癌细胞的免疫反应。为了验证这一想法，我们采用了一种动物模型来确定新鲜或储存的血液中存在的可溶性或不溶性因子的输注是否会诱导促进体内实体瘤生长的免疫调节。我们发现，输注所有同种异体血液制品都能促进肿瘤生长，储存的同系全血也是如此。无论是新鲜的同基因血液还是储存的同基因血液的上清液都不能促进肿瘤生长。同种异体和储存的同系血液中明显存在的因子相关的免疫调节在输注后7天内开始促进肿瘤生长。总之，这些研究结果强烈建议，如果可能的话，在癌症手术期间不应该输异体血。少

Allogeneic blood transfusion appears to induce immunomoduration in the recipient that may increase the likelihood of cancer recurrence. In the present study, we retrospectively analyzed patients who underwent esophagectomy for thoracic esophageal cancer and compared the outcomes of those who received allogeneic blood transfusions with those who received autologous ones. Compared were the clinicopathological factors influencing prognosis as well as the survival rates and disease-free survival. We found that theclinicopathological factors that infuluenced prognosis were similar in the two groups ; however, a definite survival advantage was evident among those who received the autologous blood transfusion. There was no significant difference in the rates at which esophageal cancer recurred or in survival time once it had recurred. On the other hand, disease-free survival prior to recurrence was significantly prolonged in patients transfused with autologous blood, and multivariate analysis … More showed autologous blood transfusion to be independent prognostic factor for the survival of patients with esophageal cancer. The results of our clinical study suggest the possibility that one or more as yet unknown mediators present in allogeneic blood suppresses immune responses to esophageal cancer cells. To test that idea, we employed an animal model to determine whether transfusion of a soluble or insoluble factors present in fresh or stored blood induces immunomoduration that promotes solid tumor growth in vivo. We found that transfusion of all allogeneic blood products enhanced tumor growth, as did stored syngeneic whole blood. Neither fresh syngeneic blood nor the supernatant from stored syngeneic blood promoted tumor growth. The immunomodulation associated with the factor(s) apparently present in allogeneic and stored syngeneic blood began to enhance tumor growthwithin 7 days after transfusion. Taken together, there findings strongly suggest that, if possible, allogeneic blood should not be transfused during cancer surgeries. Less