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王一惠, 卫勃, 李红. ABO血型与胃癌根治术患者预后的相关性探讨[J]. 解放军医学院学报, 2021, 42(2): 139-143, 171. DOI: 10.3969/j.issn.2095-5227.2021.02.004
引用本文: 王一惠, 卫勃, 李红. ABO血型与胃癌根治术患者预后的相关性探讨[J]. 解放军医学院学报, 2021, 42(2): 139-143, 171. DOI: 10.3969/j.issn.2095-5227.2021.02.004
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WANG Yihui, WEI Bo, LI Hong. Relationship between ABO blood type and prognosis of gastric cancer after radical gastrectomy[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(2): 139-143, 171. DOI: 10.3969/j.issn.2095-5227.2021.02.004
Citation: WANG Yihui, WEI Bo, LI Hong. Relationship between ABO blood type and prognosis of gastric cancer after radical gastrectomy[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(2): 139-143, 171. DOI: 10.3969/j.issn.2095-5227.2021.02.004
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ABO血型与胃癌根治术患者预后的相关性探讨

Relationship between ABO blood type and prognosis of gastric cancer after radical gastrectomy

    摘要
  • 摘要:
      背景   ABO血型是一种被广泛应用的血型分类。现有研究证实，A型血人群胃癌发病率较其他血型高，但ABO血型与胃癌预后关系的研究存在争议。
      目的   探讨胃癌预后与ABO血型的相关性。
      方法   回顾性分析2005年1月- 2008年12月于解放军总医院第一医学中心住院行根治性胃癌切除术患者资料，根据ABO血型对其分组，比较不同血型患者临床病理特征，随访截至2014年12月，通过Kaplan–Meier生存曲线和Cox回归分析不同血型患者胃癌根治术后的预后差异(pT，pN，pM投入模型1进行分析，pTNM投入模型2进行分析)。
      结果   共纳入667例患者，A型血200例，B型血207例，AB型血61例，O型血199例。不同血型组间患者年龄、性别、pT、pN、pM、pTNM分期、肿瘤细胞分化程度、饮酒史和癌症家族史无统计学差异；AB型血患者Ⅲ期胃癌比例高于其他血型患者(AB型65.6% vs A型52.2%、B型54.6%、O型50.8%)，但差异无统计学意义(P=0.486)。A型血患者吸烟比例最低，而AB型血患者吸烟比例最高(A：22.5%，B：32.9%，AB：41.0%，O：32.2%，P=0.018)。生存曲线提示A型和AB型血患者累计生存率较B型血和O型血低，但差异均无统计学意义(P＞0.05)。与O型血相比，多因素Cox回归(Model 1：HR=1.432，95% CI=1.082 ~ 1.897，P=0.012；Model 2：HR=1.329，95% CI=1.005 ~ 1.756，P=0.046)均提示A型血患者预后更差；以B型为参考，多因素Cox回归(Model 1：HR=1.549, 95% CI=1.170 ~ 2.049，P=0.002；Model 2：HR=1.412，95% CI=1.071 ~ 1.863，P=0.015)同样提示A型血患者预后更差；AB型组较O型(Model 1：HR=1.341，95% CI=0.912 ~ 1.973，P=0.136；Model 2：HR=1.140，95% CI=0.776 ~ 1.676，P=0.504)和B型(Model 1：HR=1.450, 95% CI=0.985～2.134, P=0.059；Model 2：HR=1.212，95% CI=0.827 ~ 1.776, P=0.324)组预后均更差，但差异无统计学意义。
      结论   本研究显示胃癌患者中，A型血较O型血和B型血组预后更差，血型对疾病的影响还应在不同民族中扩大样本量进一步研究。

     

    Abstract:
      Background   ABO blood type is widely used. Existing studies have confirmed that the incidence of gastric cancer in people with blood type A blood is higher, but the study of relationship between ABO blood type and the prognosis of gastric cancer is controversial.
      Objective   To explore the relationship between ABO blood type and prognosis of gastric cancer.
      Methods   From January 2005 to December 2008, gastric cancer patients received radical gastrectomy in department of general surgery in Chinese PLA General Hospital were included in this study. Patients were then divided by the blood type. Comparisons of clinical information and pathological features were taken between the groups. They were followed up until December 2014 or until death. The survival and cumulative incidence of death were analyzed according to Kaplan–Meier method. Cox regression analysis was used in the screening of prognostic risk factor (pT, pN, pM were adjusted in model 1, and pTNM was adjusted in model 2).
      Results   Of the 667 patients, there were 200 patients with blood type A, 207 patients with blood type B, 61 patients with blood type AB, and 199 patients with blood type O. No statistical difference was found in age, sex, pT, pN, pM, pTNM stage, degree of tumor cell differentiation, drinking history and family cancer history among patients with different blood types; the proportion of stage III in patients with blood type AB was higher (AB: 65.6% vs A: 52.2%, B: 54.6%, O: 50.8%, P=0.486), but the differences were not significant. Proportion of smokers was lowest in patients with blood type A and highest in blood type AB (A:22.5%, B: 32.9%, AB: 41.0%, O: 32.2%, P=0.018). Survival curves indicated that the cumulative survival rate of patients with blood type A and AB were lower than that of patients with blood type B and O, but both were without statistically significant difference (P＞0.05). Using blood type O as the reference, multivariate Cox regression suggested that the patients with blood type A had worse prognosis (Model 1: HR=1.432, 95% CI=1.082 - 1.897, P=0.012; Model 2: HR=1.329, 95% CI=1.005 - 1.756, P=0.046). Likewise, multivariate Cox regression using blood type B as the reference also suggested that the prognosis of the patients with type A blood was worse (Model 1: HR=1.549, 95% CI=1.170 - 2.049, P=0.002; Model 2: HR=1.412, 95% CI=1.071 - 1.863, P=0.015). The prognosis of the AB blood group was worse than that of the O group (Model 1: HR=1.341, 95% CI=0.912 - 1.973, P=0.136; Model 2: HR=1.140, 95% CI=0.776 - 1.676, P=0.504) and B group (Model 1: HR=1.450, 95% CI=0.985 - 2.134, P=0.059; Model 2: HR=1.212, 95% CI=0.827 - 1.776, P=0.324), but the differences were not statistically significant.
      Conclusion   This study shows that gastric cancer patients with blood type A have poor prognosis compared to those with blood type O and B. The influence of blood type on the prognosis should be further studied by expanding the sample size in different race.

     

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