输入亚临床癌症献血者血液后的癌症风险：一项回顾性队列研究

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RESOURCE:　The Lancet 2007; 369:1724-1730
来源：柳叶刀2007; 369:1724-1730
DOI:10.1016/S0140-6736(07)60779-X

TITLE: Risk of cancer after blood transfusion from donors with subclinical cancer: a retrospective cohort study
题目：受血者曾输亚临床癌症献血者血液患癌风险的回顾性队列研究
AUTHOR: Gustaf Edgren BSc a ‡, Henrik Hjalgrim MD d ‡, Prof Marie Reilly PhD a ‡, Trung Nam Tran MD a, Klaus Rostgaard MSc d, Agneta Shanwell MD b, Kjell Titlestad MD e, Johanna Adami MD a c, Agneta Wikman MD b, Casper Jersild MD f, Gloria Gridley MS g, Louise Wideroff PhD h, Prof Olof Nyrén MD a and Prof Mads Melbye MD d

Summary
摘要
Background
背景
Although mechanisms for detection of short-term complications after blood transfusions are well developed, complications with delayed onset, notably transmission of chronic diseases such as cancer, have been difficult to assess. Our aim was to investigate the possible risk of cancer transmission from blood donors to recipients through blood transfusion.
虽然对输血后短期并发症检测很完善，但对延缓发生的并发症－慢性传播性疾病如癌症却难以评估。我们的目的是研究通过输血癌传播的可能风险。
Methods
We did a register-based retrospective cohort study of cancer incidence among patients who received blood from donors deemed to have a subclinical cancer at the time of donation. These precancerous donors were diagnosed with a cancer within 5 years of the donation. Data from all computerised blood bank registers in Sweden and Denmark gathered between 1968 and 2002 were merged into a common database. Demographic and medical data, including mortality and cancer incidence, were ascertained through linkages with nationwide, and essentially complete, population and health-care registers. The risk of cancer in exposed recipients relative to that in recipients who received blood from non-cancerous donors was estimated with multivariate Poisson regression, adjusting for potential confounding factors.
方法：基于登记的受血者曾输亚临床癌症献血者的血液癌症发病率的回顾性队列研究。献血者献血后5年内确诊为癌症诊断为亚临床癌症。数据收集：1968-2002年瑞典和丹麦血库计算机登记的资料汇总。人口统计和医学数据，包括癌症的发病率和死亡率，通过全国互联网人口和卫生保健登记查明。调整可能的混淆因素，通过多元Poisson回归评估比较曾输亚临床癌症献血者血液的受血者与曾输正常献血者的血液的受血者患癌风险。
Findings
Of the 354 094 transfusion recipients eligible for this analysis, 12 012 (3%) were exposed to blood products from precancerous donors. There was no excess risk of cancer overall (adjusted relative risk 1•00, 95% CI 0•94–1•07) or in crude anatomical subsites among recipients of blood from precancerous donors compared with recipients of blood from non-cancerous donors.
结果：354094例受血者纳入分析，12 012 (3%)例受血者曾输注亚临床癌症献血者的血液。受血者总体患癌风险未增高；曾输注亚临床癌症献血者的血液的受血者与输注正常献血者的血液的受血者比较，患癌风险在病理确诊癌症亚位点亦未见明显增高。
Interpretation
Our data provide no evidence that blood transfusions from precancerous blood donors are associated with increased risk of cancer among recipients compared with transfusions from non-cancerous donors.
解释：我们的研究数据表明受血者曾输亚临床癌症献血者的血液与曾输正常献血者的血液的受血者比较，患癌风险没有增高。