Effect Of Blood Transfusion On Postoperative Immune Function And Tumor Recurrence And Metastasis In Colorectal Cancer Patients Among Different ABO Blood Types

Objective To explore the effect of intraoperative allogeneic blood transfusion on CEA and CA199 in patients with colorectal cancer with different ABO blood types,and to evaluate the impact on the patient’s immune system.Methods The experimental subjects were selected from patients with colorectal cancer who were diagnosed and treated surgically in our hospital during the two years from January 2018 to January 2020.The 80 patients selected through the screening were all patients with ASA classificationⅡ-Ⅲ,aged 25-65 years old who were diagnosed with primary colon cancer or rectal cancer.All cases underwent laparoscopic radical resection of colon cancer or rectal cancer under epidural combined with general anesthesia.Radial artery invasive arterial monitoring was performed before the operation and arterial blood gas analysis was performed through this method.According to Hb（Hemoglobin,hemoglobin）content and surgery The vital signs of the middle-aged patient were treated with homologous blood transfusion.The blood transfusion standard refers to the"Expert Consensus on Perioperative Blood Transfusion"issued by the Chinese Medical Association Anesthesiology Branch.Hemoglobin<70 g/L requires blood transfusion;hemoglobin between 70 and100 g/L depends on the patient’s cardiopulmonary compensatory function and the patient’s intraoperative life The physical signs,intraoperative blood loss,and the joint evaluation of the surgeon and the anesthesiologist decided to give the patient an allogeneic white-suspension red blood cell transfusion.According to different ABO blood types,patients undergoing intraoperative blood transfusion were divided into four groups:A,B,AB,and O.Among them,40 were males and 40 were females,including 23 patients with right colon cancer and 27 patients with left colon cancer.There are 30 cancer patients.To define the value range of CEA,take CEA≥5ng/ml as elevated;CEA<5ng/ml as normal.For the value range of CA199,take CA199≥40U/ml as an increase;CA199<40U/ml as normal.All patients were collected peripheral venous blood before surgery（T₀）,1 day after blood transfusion（T₁）,3 days after blood transfusion（T₂）,and 7 days after blood transfusion（T₃）at 9 o’clock in the morning on an empty stomach.Serum was collected after centrifugation.Chemiluminescence immunoassay technology measured the levels of CEA and CA199 in the patient’s serum.Analysis of variance was performed between groups to compare the content of tumor markers at different time points and observe their changing trends.Repeated measures analysis of variance was used to compare the differences between patients with different blood types at each time point in the different blood type groups.Follow up the patients after they are discharged from the hospital.To explore the effect of homologous blood transfusion on tumor markers in patients with different ABO blood types,and to analyze the relationship between blood transfusion and the immune function of patients with different blood types and tumor conversion in combination with the patient’s prognosis.Results 1.Colorectal cancer patients with different ABO blood types have no significant differences in age,gender,body mass index,preoperative tumor marker content,tumor location and blood transfusion volume.2.The tumor markers began to decrease after surgery and blood transfusion,and the degree of decrease was statistically different than that before surgery.3.Under the trend of declining tumor markers,there is no significant difference between the three groups A,B,and O,but the tumor markers of AB blood group patients decrease faster than the other three groups.4.There is no significant difference in the prognosis of patients with different ABO blood types within 1 year.Conclusion Intraoperative blood transfusion will inhibit the immune system of patients with colorectal cancer and slow down the decline of tumor markers in patients with blood types A,B,and O.However,this effect is not obvious in patients with blood type AB.The immune function of patients with blood type AB is affected by blood transfusion.The impact is minimal.There is no significant difference in the prognosis of patients with different ABO blood types within 1 year.