ABO blood group and risk of cancer: A register-based cohort study of 1.6 million blood donors

Association of Leukemia With ABO Blood Group Distribution and Discrepancy: A Review Article

The ABO system is an essential blood group in clinical transfusion medicine implicated in several human diseases. The ABO system has been investigated for over a century, with various studies exploring potential links to disease susceptibility. The study examines the possible relationship between leukemia and the distribution and the ABO blood group system discrepancy. A comprehensive review was conducted on the recommended databases to review the ABO blood groups, their association with leukemia, and the expected changes in blood groups among leukemia patients. The study highlights different kinds of leukemia, such as acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL), their characteristics, and their relationship with ABO blood groups. The document concludes that studying ABO blood group distributions among leukemia patients showed that the most common blood group in acute leukemia is the A group, while in chronic leukemia, the O group is predominant; more studies are required. This study also confirmed an association between leukemia and ABO blood group discrepancy.

ABO blood type and functional neurological outcome in patients with severe traumatic brain injury

BACKGROUND

The ABO blood system has been involved in the pathogenesis of several diseases, including coagulopathy and bleeding complications. In trauma patients, blood type A has been associated with acute respiratory distress syndrome, and recently, blood type O has been associated with all-cause mortality. The purpose of this study was to assess the association between ABO blood types and long-term functional outcomes in critically ill patients with severe traumatic brain injury (TBI).

METHODS

We conducted a single-center, retrospective, observational study including all patients admitted to the intensive care unit with severe TBI (defined as a Glasgow Coma Scale score of ≤8) between January 2007 and December 2018. Patient characteristics and outcomes were extracted from a prospective registry of all intubated patients admitted to the intensive care unit for TBI. ABO blood types were retrospectively retrieved from patient medical records. The association between ABO blood type (A, B, AB, and O) and unfavorable functional outcome (defined by a Glasgow Outcome Scale score between 1 and 3) 6 months after injury was assessed in univariate and multivariate analysis.

RESULTS

A total of 333 patients meeting the inclusion criteria were included. There were 151 type O (46%), 131 type A (39%), 37 type B (11%), and 12 type AB patients (4%). No significant differences in baseline demographic, clinical, or biological characteristics were observed between blood types. The prevalence of unfavorable outcome was significantly different between the four groups. After adjustment for confounders, blood type O was significantly associated with unfavorable outcome at 6 months (odds ratio, 1.97; confidence interval [1.03-3.80]; p = 0.042). The prevalence of coagulopathy or progressive hemorrhagic injury was not statistically different between blood types ( p = 0.575 and p = 0.813, respectively).

CONCLUSION

Blood type O appears to be associated with unfavorable long-term functional outcome in critically ill patients with severe TBI. Further studies are needed to detail the mechanism underlying this relationship.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level IV.

Distribution of ABO blood groups and Rh factor in benign and malign thyroid nodules

Aim: Many factors affect the diagnostic value of the fine-needle aspiration biopsy applied for these thyroid nodules. I aimed to investigate whether one of these factors would be ABO blood groups and Rh factor and examine the relationship of these factors with the Bethesda categorization. Additionally, I aimed to evaluate ABO blood groups and Rh factors in patients with thyroid cancer. Material and Method: This study was planned in a cross-sectional retrospective design. The data of the patients were obtained from the hospital data bank. In the analysis of 801 patients following the acceptance criteria, 412 patient data were obtained. Patients were divided into 4 (O, A, B, and AB groups) according to their blood groups and analyzed for nodules (solitary/ multinodular). Nodules were divided into malignant and benign, according to histopathological diagnosis, and all were analyzed. Results: There was no difference in analyzing the demographic data according to the blood groups. The rates of the FNAB history were 51 (32.3%), 39 (24.2%), 14 (26.4%), and 13 (32.5%) in the same order of blood groups (p=0.393). In the analysis of the nodule type, multinodular did not differ from solitary nodules among the blood groups [O: 141 (89.2%); A:140(87%), B: 46(86.8%), and AB: 35(87.5%)]. Thyroid function status (euthyroid, hypothyroid, or hyperthyroid) was similar for all the blood groups (p=0.815). The O-group had 1 (0.6%) patient with Bethesda score-6, and the A-group had 2 (1.2%) patients with Bethesda score-6. For Bethesda score-5, per blood group had 2 patients. The histopathological distribution of malign nodules (p=0.782) is as follows: O-groups: 6 (33.3%) (Rh+:27%; Rh-:5,5%), A groups: 7(63,6%) (Rh+:54,5%; Rh-:0,9%), B groups: 2(20%)(Rh+:20%; Rh-:0%) and AB groups: 1(33%) (Rh+:33%) Rh-:0%). Conclusion: Malign nodule rate was highest in the A-group and lowest in the B groups, although it did not differ in the overall analysis. No relationship was found between the Bethesda categorization of nodules, their sizes, type of nodules, type of thyroid cancer, and ABO blood groups.

Influence of ABO blood group on susceptibility to different pathological types of lung cancer: a retrospective study

Purpose

Current research has shown a link between ABO blood group and many diseases. The purpose of this study aimed to investigate the influence of the ABO blood group on the risk of developing different pathological types of lung cancer.

Materials and methods

This retrospective study was composed of 7681 patients with lung cancer and 12, 671 non-lung cancer patients who were admitted to the First Affiliated Hospital of Nanchang University from January 2016 to January 2021. The subjects with lung cancer were grouped into small cell lung cancer group (n = 725), lung adenocarcinoma group (n = 4520), and lung squamous cell carcinoma group (n = 2286) according to pathological types. The ABO blood group distribution of each lung cancer type group was compared with that of the control group. Statistical analysis was determined with chi-square and logistic regression.

Results

Univariate analysis showed that the ABO blood group distribution of lung adenocarcinoma, lung squamous cell carcinoma, and small cell lung cancer was different from that of the control group (P < 0.01). After adjusting for age, sex, smoking history, and drinking history, logistic regression analysis showed that the risk of lung adenocarcinoma in blood type O was higher than that in blood type A (P < 0.01). There was no significant difference in ABO blood group composition between small cell lung cancer group, lung squamous cell carcinoma group, and control group (P > 0.05). In addition, gender and age have an influence on all three types of lung cancer (P < 0.01). Smoking was a risk factor in lung squamous cell carcinoma and small cell carcinoma (P < 0.01). Alcohol consumption was a risk factor in lung adenocarcinoma (P < 0.01).

Conclusion

ABO blood group may be correlated with the occurrence of lung adenocarcinoma in Jiangxi province, but not with lung squamous cell carcinoma and small cell carcinoma.

The frequency and prognostic significance of ABO/Rh blood groups in male breast cancer patients: A multicenter study

The study evaluated the distributions and prognostic significance of ABO and rhesus (D) groups in male breast cancer (MBC) patients. The data of 137 patients were retrospectively reviewed. Clinical, histopathological data and ABO/Rh blood groups of the patients were recorded. The ABO/Rh blood group distributions were compared to the healthy men control group (n = 120,160) by the chi-square test. Overall distributions of ABO blood groups were different between the patients (17.5% AB, 38% A, 19% B, and 25.5% O) and control group (7.88% AB, 42.06% A, 15.22% B, and 34.84% O) (P < .001). There were significant differences between the patients and control group with respect to AB vs non-AB blood group distributions (P < .001, odds ratio: 2.43, 95% CI) and O vs non-O blood group distributions (P = .016, odds ratio: 0.62, 95% CI). However, A vs non-A and B vs non-B blood group distributions were not significantly different. The distribution of the Rh factor was similar between patients and the control group (P = .93). In univariate analysis, ABO/Rh blood groups were not a prognostic factor on OS (P = .29). The frequency of the AB blood group in MBC patients is increased than in the healthy control group. AB blood group may be a risk factor for MBC, whereas O blood group may be a protective factor.

Modifiable and Non-Modifiable Risk Factors for the Development of Non-Hereditary Pancreatic Cancer

Pancreatic cancer is becoming an increasing healthcare concern. Though it is a 14th most common cancer worldwide, its incidence is steadily rising. Results of currently available therapies are still not satisfactory. Therefore, great attention should be put on the identification and reduction of risk factors for pancreatic cancer. A thorough up-to-date review of available data on the impact of well-established and novel risk factors of pancreatic cancer development have been performed. Several risk factors associated with lifestyle have significant impact on the risk of pancreatic cancer (i.e., smoking, obesity, alcohol consumption). Physicians should also be aware of the novel findings suggesting increasing role of microbiome, including viral and bacterial infections, in the development of pancreatic cancer. A growing body of evidence suggest also an increased risk during certain occupational exposures. In general, lifestyle seems to be a major contributor in the development of pancreatic cancer. Special attention should be given to individuals with a vicious cluster consisting of metabolic syndrome, tobacco smoking and alcohol consumption. Physicians should urge patients to comply to healthy diet, cessation of smoking and moderation of alcohol consumption, which may halve pancreatic cancer incidence. Further studies are warranted to explore the potential use of therapeutic approach on novel risk factors (e.g., microbiome).

Environmental and genetic risk factors for gastric cancer

Gastric cancer is a heterogeneous and prevalent disease. The traditional environmental exposures associated with an elevated risk of gastric cancer are less prevalent in the United States today. Genetic risks and risks associated with inflammation remain. Most cases are sporadic and familial clustering is observed in about 10% of the cases. Hereditary gastric cancer accounts for a very low percentage of cases. Here we review the genetic and environmental risk factors associated with the disease.

ABO blood group distribution and risk of malignancy in patients undergoing resection for intraductal papillary mucinous neoplasm (IPMN)

BACKGROUND

The ABO blood type has been associated with risk of development of several malignancies, including pancreatic cancer. Data regarding IPMN is equivocal. To investigate this further, we analyzed the association between the ABO blood group and the presence of malignancy in a large cohort of resected IPMN and its influence in survival.

METHODS

819 patients who underwent pancreatic resection for IPMN in the Massachusetts General Hospital (MGH) and Cambridge University Hospitals NHS Foundation Trust (CUH) from January 1993 to December 2020 were identified from prospective institutional databases. Pathological characteristics and blood type were correlated.

RESULTS

The distribution of blood types A, B, AB and O was 384 (47%), 92 (11%), 44 (5%) and 299 (37%), respectively. This blood type distribution was different than the reference population of the MGH and the CUH, which is 55% non-O blood group, and 45% type O. There was a significant predominance of non-O blood types when compared with O-blood type in patients with malignant IPMN (i.e. patients with high-grade dysplasia and invasive cancer) (67% vs 33%, OR 1.31 95%CI: 0.98-1.75, p = 0.069). The association was stronger for IPMN with invasive cancer (OR 1.43 95%CI: 1.01-2.02, p = 0.039). Blood group did not influence survival.

CONCLUSION

Non-O blood type is associated with need for resection in IPMN and with presence of invasive carcinoma.

ABO blood group and Rh factor distributions in patients with epilepsy

OBJECTIVE

We investigated the ABO blood group and Rh factor distributions in patients with epilepsy (PWE) in comparison with a comparator population.

METHODS

We recruited patients who were admitted to the epilepsy ward at Namazi hospital in Shiraz, Iran, in 2021. We classified epilepsies into two categories: focal vs. generalized. We also used the anonymous data from Fars Blood Transfusion Organization from 15th June to 30th June, 2021, as the comparator population (to estimate the frequencies of various blood types in the cohort from which PWE were recruited).

RESULTS

Overall, 390 PWE were included [131 (33.6%) with generalized and 259 (66.4%) with focal epilepsy]. We also included 7672 blood donors [from Fars Blood Transfusion Organization data]. The O phenotype had the highest frequencies in both PWE and the comparator population, followed by A, B, and AB blood groups. Similar patterns were observed in patients with focal and generalized epilepsy. With regard to Rh blood group, the Rh-positive phenotype was more prevalent in all groups. The differences between the groups were not significant in any of the comparisons.

CONCLUSION

While we did not observe any significant associations between blood group and epilepsy in the current study, previous studies have demonstrated compelling evidence that risks of some neuropsychiatric disorders are related to the chemistry of blood, including blood group classification. The issue of the association between epilepsy and blood group should be investigated in large and well-designed studies in the future.

ABO blood group is not a predictive factor for the amount of early opioid consumption in postanesthesia care unit: a prospective cohort study in 3,316 patients

Background

Immediate postoperative pain in the postanesthesia care unit (PACU) is common. Titration of opioid is the most popular strategy for controlling early postoperative pain. ABO blood group has been found to be associated with pain perception. We aimed to find the factors including ABO blood group for predicting the amount of opioid requirement in PACU.

Methods

This prospective cohort study was performed in 3316 patients who underwent various kinds of anesthetic techniques and received immediate postoperative care in PACU. Preoperative, intraoperative and PACU data were collected. A directed acyclic graph (DAG) representing the hypothesized causal pathways of preoperative, intraoperative and PACU data were compiled prior to conducting multinomial logistic regression analysis. Statistical significance in all models was defined as a P-value < 0.05.

Results

Female sex, body mass index, preoperative use of gabapentin, preoperative anxiety score, anesthetic techniques, type of operation, amount of consumed intraoperative opioids, intraoperative use of paracetamol, parecoxib and ondansetron, duration of anesthesia and surgery, amount of blood loss, pain upon PACU arrival, use of paracetamol and parecoxib in PACU were found to be factors influencing amount of opioid consumption in PACU. ABO blood group was not associated with early postoperative opioid requirement.

Conclusions

A significant number of factors are related to amount of opioid requirement in PACU. Some factors can be adjusted to provide better pain relief in early postoperative period. However, ABO blood group is not identified to be a predictive factor for early postoperative opioid consumption in PACU.

ABO blood group and skin cancers

Beside the role of ABO group in immunohaematology, there is accumulating evidence that the ABO blood group also plays a key role in various human disorders. The interest in blood groups and their association with disease stems from the awareness that blood group antigens are incredibly important components in the process of cell maturation and control. Studies have indicated a link between cancer and the ABO blood group. The appearance or disappearance of blood type antigens is now considered a hallmark of malignancy in many common cancers. Several tumour markers are in fact known blood group antigens. The aim of this review is to describe the history and possible functions of the ABO group and then summarize the association between blood groups and skin cancers.

Pancreatic cancer: A review of epidemiology, trend, and risk factors

Despite rapid advances in modern medical technology and significant improvements in survival rates of many cancers, pancreatic cancer is still a highly lethal gastrointestinal cancer with a low 5-year survival rate and difficulty in early detection. At present, the incidence and mortality of pancreatic cancer are increasing year by year worldwide, no matter in the United States, Europe, Japan, or China. Globally, the incidence of pancreatic cancer is projected to increase to 18.6 per 100000 in 2050, with the average annual growth of 1.1%, meaning that pancreatic cancer will pose a significant public health burden. Due to the special anatomical location of the pancreas, the development of pancreatic cancer is usually diagnosed at a late stage with obvious clinical symptoms. Therefore, a comprehensive understanding of the risk factors for pancreatic cancer is of great clinical significance for effective prevention of pancreatic cancer. In this paper, the epidemiological characteristics, developmental trends, and risk factors of pancreatic cancer are reviewed and analyzed in detail.

Prognostic relevance of ABO blood group system in non-metastatic renal cell carcinoma: An analysis of two independent European cohorts with long-term follow-up

BACKGROUND

The ABO blood group system has been previously discussed as a risk factor to develop, as well as a prognostic factor in non-metastatic renal cell carcinoma (RCC). Controversial findings have been reported in different populations of RCC patients with rather short follow-up periods. In this study, we aimed to clarify the distribution and prognostic role of ABO blood groups upon 15 years of median follow-up in non-metastatic RCC patients.

MATERIALS AND METHODS

We evaluated the distribution and prognostic significance of ABO blood group system in two independent cohorts (n = 405 and n = 1473) of non-metastatic RCC patients, who underwent curative (partial or total) nephrectomy between 1998 and 2012 at two tertiary academic centers. Cancer-specific survival, metastasis-free survival, as well as overall survival (OS) were assessed using the Kaplan-Meier method, univariable- and multivariable Cox regression models were applied, respectively.

RESULTS

In the two cohorts, blood groups were not associated with any clinical endpoints (for cohort 2: Cancer-specific survival (HR = 1.233; 95%CI 0.998-1.523, P = 0.052), metastasis-free survival (HR = 1.161; 95%CI 0.952-1.416, P = 0.142) and OS (HR = 1.037; 95%CI 0.890-1.208, P = 0.641), respectively). Compared to 250.298 healthy blood-donors of the Styrian state, the distribution of blood groups was (624 (42.4%) versus 106.861 (42.7%) in group A, 191 (13%) vs. 34.164 (13.7%) in group B, 575 (39%) versus 93.579 (37.4%) in group O and 83 (5.6%) vs. 15.694 (6.3%), P = 0.467).

CONCLUSION

In this large study with the longest period of follow-up reported to date, the ABO blood group system could not be validated as a prognostic factor in predicting important clinical endpoints in non-metastatic RCC patients.

Association between ABO and Duffy blood types and circulating chemokines and cytokines

Blood group antigens are inherited traits that may play a role in immune and inflammatory processes. We investigated associations between blood groups and circulating inflammation-related molecules in 3537 non-Hispanic white participants selected from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Whole-genome scans were used to infer blood types for 12 common antigen systems based on well-characterized single-nucleotide polymorphisms. Serum levels of 96 biomarkers were measured on multiplex fluorescent bead-based panels. We estimated marker associations with blood type using weighted linear or logistic regression models adjusted for age, sex, smoking status, and principal components of population substructure. Bonferroni correction was used to control for multiple comparisons, with two-sided p values < 0.05 considered statistically significant. Among the 1152 associations tested, 10 were statistically significant. Duffy blood type was associated with levels of CXCL6/GCP2, CXCL5/ENA78, CCL11/EOTAXIN, CXCL1/GRO, CCL2/MCP1, CCL13/MCP4, and CCL17/TARC, whereas ABO blood type was associated with levels of sVEGFR2, sVEGFR3, and sGP130. Post hoc pairwise t-tests showed that individuals with type Fy(a+b−) had the lowest mean levels of all Duffy-associated markers, while individuals with type A blood had the lowest mean levels of all ABO-associated markers. Additional work is warranted to explore potential clinical implications of these differences.

ABO Blood Groups and Its Association with Oral Cancer, Oral Potentially Malignant Disorders and Oral Submucous Fibrosis- A Systematic Review and Meta-Analysis

Objective:

The study aimed to evaluate the association between ABO blood groups and oral cancer, other potentially malignant disorders (OPMD), and oral submucous fibrosis (OSMF).

Materials and methods:

A search was conducted in Medline, Cochrane databases, Google Scholar, Scopus, Web of Science and Directory of Open Access Journals (DOAJ) for studies evaluating ABO blood groups as risk factors for oral cancer and OPMD among cases and controls. The PRISMA guidelines were followed for the meta-analysis. Participants included patients with oral cancer, and OPMD diagnosed using histopathologic investigations. Sub-group analysis was conducted to evaluate the association between blood groups and OSMF. Quality was evaluated using the Risk of Bias Assessment tool. Fixed effects model was used to assess the odds ratio for the association.

Results:

There were 1,352, 414, and 299 cases of oral cancer, OPMD, and OSMF and 11,699, 7,382 and 7,307 controls for analysis respectively. Blood group A was significantly associated with both oral cancer (Odds ratio: 1.27 [95% CI, 1.10, 1.47], P= 0.001) and OPMD (Odds ratio: 1.33 [95% CI, 1.01, 1.47], P= 0.04). No association was noted between blood group B and AB with oral cancer, OPMD, and OSMF. Blood group O was significantly associated with lower chances of oral cancer (Odds ratio: 0.81 [95% CI, 0.71, 0.93], P= 0.002).

Conclusion:

Meta-analysis suggests blood group A has a greater risk for developing oral cancer and OPMD. Blood group O was associated with lower chances of oral cancer. No association was noted between ABO blood group system with OSMF.

An agnostic study of associations between ABO and RhD blood group and phenome-wide disease risk

Background

There are multiple known associations between the ABO and RhD blood groups and disease. No systematic population-based studies elucidating associations between a large number of disease categories and blood group have been conducted.

Methods

Using SCANDAT3-S, a comprehensive nationwide blood donation-transfusion database, we modeled outcomes for 1217 disease categories including 70 million person-years of follow-up, accruing from 5.1 million individuals.

Results

We discovered 49 and 1 associations between a disease and ABO and RhD blood groups, respectively, after adjustment for multiple testing. We identified new associations such as a decreased risk of kidney stones and blood group B as compared to blood group O. We also expanded previous knowledge on other associations such as pregnancy-induced hypertension and blood groups A and AB as compared to blood group O and RhD positive as compared to negative.

Conclusions

Our findings generate strong further support for previously known associations, but also indicate new interesting relations.

Funding

Swedish Research Council.

Risk factors for postpartum depression in Chinese women: A cross-sectional study at 6 weeks postpartum

OBJECTIVE

Postpartum depression (PPD) has received increasing attention due to its harmful impacts and high incidence. PPD is affected by physiological and psychological factors, but the conclusions are not uniform at present, so this study explored the risk factors of postpartum depressive symptoms (PPDS) in Chinese population.

METHODS

A total of 397 women attending the obstetric department of the First Affiliated Hospital of Wenzhou Medical University participated in the questionnaire survey, mainly through a cross sectional study. At 6 weeks postpartum, the Edinburgh Postpartum Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess PPDS and sleep quality, respectively.

RESULTS

The incidence of probable PPDS in our study population was 14.6% at 6 weeks postpartum. Women with blood group A had an almost 3-fold greater risk of PPDS than those with blood group B (OR [95% CI], 2.99 [1.43-6.28], p = 0.004). After adjusting for potential confounding variables, the blood group A phenotype was significantly more prevalent in women with PPDS compared to blood group B (OR [95% CI], 2.65 [1.23-5.70], p = 0.01).

CONCLUSIONS

Compared to women with blood groups B, AB or O, women with blood group A had high odds of PPDS. If this result can be demonstrated and replicated in other populations, blood group A may be a useful predictor of risk for PPDS in Chinese postpartum women.

Detecting Early Pancreatic Cancer: Current Problems and Future Prospects

The number of patients with pancreatic cancer (PC) is currently increasing in both Korea and Japan. The 5-year survival rate of patients with PC 13.0%; however, resection with minimal invasion (tumor size: ≤10 mm) increases the 5-year survival rate to 80%. For this reason, early detection is essential, but most patients with early-stage PC are asymptomatic. Early detection of PC has been reported to require screening of high-risk individuals (HRIs), such as those with a family history of PC, inherited cancer syndromes, intraductal papillary mucinous neoplasm, or chronic pancreatitis. Studies on screening of these HRIs have confirmed a significantly better prognosis among patients with PC who were screened than for patients with PC who were not screened. However, to date in Japan, most patients with early-stage PC diagnosed in routine clinics were not diagnosed during annual health checks or by surveillance; rather, PC was detected in these patients by incidental findings during examinations for other diseases. We need to increase the precision of the PC screening and diagnostic processes by introducing new technologies, and we need to pay greater attention to incidental clinical findings.

The Swedish Scandinavian donations and transfusions database (SCANDAT3-S) - 50 years of donor and recipient follow-up

Background

The two previous versions of the Scandinavian donations and transfusions (SCANDAT) databases, encompassing data on blood donors, blood components, transfusions, and transfused patients linked to national health registers in Sweden and Denmark up until 2012, have been used to study donor health, disease transmission, the role of donor characteristics, and more.

Study Design and Methods

Here we describe the creation of the Swedish portion of the third iteration of SCANDAT – SCANDAT3‐S – with follow‐up from 1968 to the end of 2017, resulting in up to 50 years of uninterrupted follow‐up for donors and recipients. The database now also includes non‐transfused non‐donors with a blood typing result, increased temporal resolution for transfusions, and linkages to laboratory and drug prescription data.

Results

After data cleaning, the database contained 23 579 863 donation records, 21 383 317 transfusion records, and 8 071 066 unique persons with valid identification. In total, the database offers 28 638 436 person‐years of follow‐up for donors, 13 582 350 person‐years of follow‐up for transfusion recipients, and 65 613 639 person‐years of follow‐up for non‐recipient non‐donors, with possibility for future extension. Additionally, the database includes 167 820 412 dispense records for prescribed drugs and 316,338,442 laboratory test results. Since the latest update in 2012, >99.9% of all donations were traceable to a donor with valid identification, and >97% of all transfusions to a recipient with valid identification.

Conclusion

With extended follow‐up and more clinical detail, the Swedish portion of the third and latest iteration of the SCANDAT database should allow for more comprehensive analysis of donation and transfusion‐related research questions.

The ABO Blood Group Impacts the Survival of Patients Undergoing Pancreatoduodenectomy for Biliary Tract Cancer

BACKGROUND/AIM

Although ABO blood group has been reported to be associated with the outcome of patients with pancreatic cancer, little is known about its impact on patients with biliary tract cancer (BTC). We evaluated the prognostic relevance of ABO blood group in patients who had undergone resection of BTC.

PATIENTS AND METHODS

A total of 154 patients with BTC undergoing pancreatoduodenectomy were retrospectively reviewed. Associations between ABO blood group and patient survival were evaluated by univariate and multivariate analysis.

RESULTS

The 5-year overall survival rate was higher in group O patients (n=46) than in other blood group patients (n=108) (65.8% vs. 47%, p=0.005). Multivariate analysis revealed that a non-O blood group was an independent risk factor for poor survival (p=0.021).

CONCLUSION

ABO blood group is associated with the prognosis of patients with resected BTC; group O patients have a better outcome.

ABO Blood Groups, Rh Factor, and Thyroid Cancer Risk: To 'B' or Not to 'B'

Purpose: In this study, we aimed to evaluate ABO blood groups and Rh factor in patients with thyroid cancer.Methods: Demographical and clinical features, cytological results, ABO blood groups, and Rh factor status of patients with benign and malignant thyroid disease were evaluated. Histopathological features of thyroid cancer were compared in Rh positive and negative patients, and patients with different ABO blood groups.Results: Histopathological diagnosis was benign in 1,299 (63.5%) and malignant in 744 (36.5%) patients. There was no significant difference between benign and malignant patients in terms of age, sex, thyroid autoantibody positivity, and ABO blood groups (p > .05 for each). A significantly higher rate of patients with malignant disease were Rh positive compared to patients with benign disease (91.8% vs. 88.1%, p = .046). In thyroid cancer patients, extrathyroidal extension and advanced stage (3-4) were observed more frequently in patients with B compared to non-B blood groups (p = .028 and 0.042, respectively). The likelihood of the extrathyroidal extension was 4.272 (95%: 1.816-10.049) times higher in B blood group compared to non-B blood groups in patients with multifocal disease (p < .001). Patients with O blood group had lower rate of capsular invasion than patients with non-O blood groups (p = .018).Conclusion: Patients with B blood group had higher risk of extrathyroidal extension and advanced stage compared to patients with non-B blood group.

Pleiotropy of ABO gene: correlation of rs644234 with E-selectin and lipid levels

BACKGROUND

The ABO gene has been widely studied and associated with many different diseases such as myocardial infarction and diabetes. Pleiotropic effects of the ABO locus have been demonstrated. Indeed it affects different phenotypes such as E- and P-selectins, triglycerides and total cholesterol. The goal of this work was to study the SNP rs644234 located in the ABO gene with different phenotypes related with diseases where the ABO gene has been involved.

METHODS

We analyzed the SNP rs644234 located in the ABO gene, by performing association studies with different lipid phenotypes as well as with the soluble E-selectin levels in 348 adults from the STANISLAS Family Study.

RESULTS

The major rs644234*T allele was associated with increased levels of soluble E-selectin (p=8.7×10-12). According to the lipid phenotypes, the major rs644234*T allele was associated with decreased levels of apolipoproteins E (ApoE) (p=0.001) and low-density lipoprotein cholesterol (LDL-C) (p=0.032) but was associated with increased levels of high-density lipoprotein cholesterol (HDL-C) (p=0.013). The association of the HDL-C was especially significant in the male individuals (p=0.001).

CONCLUSIONS

We confirmed that ABO is a major locus for serum soluble E-selectin levels variability, and we also correlated this gene with different lipid phenotypes. Furthermore, we demonstrated that this pleiotropic effect is independent. This is the first time that a correlation has been made between the ABO gene and the ApoE levels. According to these results, the major allele of this polymorphism may have a protective effect when it comes to cardiovascular related diseases, and more specifically when it comes to the lipid phenotypes.

ABO blood group polymorphism has an impact on prostate, kidney and bladder cancer in association with longevity

The aim of the present study was to assess the ABO blood group polymorphism association with prostate, bladder and kidney cancer, and longevity. The following data groups were analyzed: Prostate cancer (n=2,200), bladder cancer (n=1,530), renal cell cancer (n=2,650), oldest-old (n=166) and blood donors (n=994) groups. The data on the ABO blood type frequency and odds ratio in prostate cancer patients revealed a significantly higher blood group B frequency (P<0.05); the pooled men and women, separate men bladder cancer risk was significantly associated with the blood group B (P<0.04); however, no such association was identified in the female patients. The blood group O was observed to have a significantly decreased risk of bladder cancer for females (P<0.05). No significance for the ABO blood group type in the studied kidney cancer patients was identified. A comparison of the oldest-old and blood donor groups revealed that blood group A was significantly more frequent and blood type B was significantly rarer in the oldest-olds (P<0.05). The results of the present study indicated that blood type B was associated with the risk of prostate and bladder cancer, and could be evaluated as a determinant in the negative assocation with longevity. Blood types O and A may be positive factors for increasing the oldest-old age likelihood. The clustering analysis by the ABO type frequency demonstrated that the oldest-olds comprised a separate cluster of the studied groups.

Prognostic role of ABO blood group in patients with unresectable hepatocellular carcinoma after transarterial chemoembolization

Background

The association of ABO blood group with prognosis of several malignancies has been established. However, its role in hepatocellular carcinoma (HCC) remains unclear.

Patients and methods

In this study, we investigated the prognostic role of ABO blood group in unresectable HCC patients receiving transarterial chemoembolization (TACE) as an initial treatment. Medical records of 2,611 HCC patients were collected, and clinical data of 282 unresectable HCC patients receiving TACE were ultimately analyzed retrospectively. A prognostic nomogram was generated for predicting 1-, 2-, and 3-year overall survival (OS) probability. A total of 114 (40.4%), 69 (24.5%), 64 (22.7%), and 35 (12.4%) HCC patients had blood groups O, A, B, and AB, respectively.

Results

The median OS times for patients with blood groups O, A, B, and AB were 24, 23, 20, and 20 months, respectively. Patients with blood group AB (hazard ratio [HR]=2.050, 95% confidence interval [CI], 1.331–3.157, P=0.001) or group non-O (HR=1.479, 95% CI, 1.110–1.972, P=0.008) had a poorer OS than those with blood group O. The prognostic nomogram, with a c-index of 0.701, was modest in predicting OS of unresectable HCC patients.

Conclusion

Patients with non-O blood group, particularly blood group AB, had a worse OS compared with those having blood type O. ABO blood group can predict the prognosis in patients with unresectable HCC undergoing TACE as an initial therapy. Further external validation in larger cohorts is necessary to confirm their usefulness in clinical practice.

Position of human blood group O(H) and phenotype-determining enzymes in growth and infectious disease

The human ABO(H) blood group phenotypes arise from the evolutionarily oldest genetic system found in primate populations. While the blood group antigen A is considered the ancestral primordial structure, under the selective pressure of life‐threatening diseases blood group O(H) came to dominate as the most frequently occurring blood group worldwide. Non‐O(H) phenotypes demonstrate impaired formation of adaptive and innate immunoglobulin specificities due to clonal selection and phenotype formation in plasma proteins. Compared with individuals with blood group O(H), blood group A individuals not only have a significantly higher risk of developing certain types of cancer but also exhibit high susceptibility to malaria tropica or infection by Plasmodium falciparum. The phenotype‐determining blood group A glycotransferase(s), which affect the levels of anti‐A/Tn cross‐reactive immunoglobulins in phenotypic glycosidic accommodation, might also mediate adhesion and entry of the parasite to host cells via trans‐species O‐GalNAc glycosylation of abundantly expressed serine residues that arise throughout the parasite's life cycle, while excluding the possibility of antibody formation against the resulting hybrid Tn antigen. In contrast, human blood group O(H), lacking this enzyme, is indicated to confer a survival advantage regarding the overall risk of developing cancer, and individuals with this blood group rarely develop life‐threatening infections involving evolutionarily selective malaria strains.

Top ten errors of statistical analysis in observational studies for cancer research

Observational studies using registry data make it possible to compile quality information and can surpass clinical trials in some contexts. However, data heterogeneity, analytical complexity, and the diversity of aspects to be taken into account when interpreting results makes it easy for mistakes to be made and calls for mastery of statistical methodology. Some questionable research practices that include poor analytical data management are responsible for the low reproducibility of some results; yet, there is a paucity of information in the literature regarding specific statistical pitfalls of cancer studies. In addition to proposing how to avoid or solve them, this article seeks to expose ten common problematic situations in the analysis of cancer registries: convenience, dichotomization, stratification, regression to the mean, impact of sample size, competing risks, immortal time and survivor bias, management of missing values, and data dredging.

Epidemiology of donors and recipients: lessons from the SCANDAT database

With the development of several 'vein-to-vein' databases, which capture data on the entire donor-recipient continuum and link this data to health outcomes, there has been an increasing number of studies investigating the health effects of all aspects of the practice of transfusion medicine. The Scandinavian Donations and Transfusions (SCANDAT) database is one of several such databases, which includes all electronically available data on blood donors, donations and transfusions since the late 1960s in Sweden and the early 1980s in Denmark. The SCANDAT database has been used to characterise disease occurrence among blood donors and transfused patients, as well as to investigate possible health effects of blood donations, aspects of transfusion care and possible transfusion transmission of disease. Recent publications include studies on recipient mortality associated with the storage lesion, studies on the effects of donor demographics on patient mortality and health effects of frequent blood donation. Although this research approach is clearly very powerful, the appropriate analysis of such real-world data is complex and requires close methodological attention. The purpose of this review is to present some of the research conducted within the SCANDAT collaboration. We hope more international collaboration may help improve our understanding of the important remaining questions about donor and recipient health.

Associations between ABO blood groups and pancreatic ductal adenocarcinoma: influence on resection status and survival

Both serology-based and genetic studies have reported an association between pancreatic cancer risk and ABO blood groups. We have investigated this relationship in a cohort of pancreatic cancer patients from Western Norway (n = 237) and two control materials (healthy blood donors, n = 379; unselected hospitalized patients, n = 6149). When comparing patient and blood donor ABO allele frequencies, we found only the A1 allele to be associated with significantly higher risk for pancreatic ductal adenocarcinoma (PDAC) (23.8% vs. 17.9%; OR = 1.43, P = 0.018). Analyzing phenotypes, blood group A was more frequent among PDAC cases than blood donors (50.8% vs. 40.6%; OR = 1.51, P = 0.021), an enrichment fully explained by the A1 subgroup. Blood group O frequency was lower in cases than in blood donors (33.8% vs. 42.7%; OR = 0.69, P = 0.039). This lower frequency was confirmed when cases were compared to hospitalized patients (33.8% vs. 42.9%; OR = 0.68, P = 0.012). Results for blood group B varied according to which control cohort was used for comparison. When patients were classified according to surgical treatment, the enrichment of blood group A was most prominent among unresected cases (54.0%), who also had the lowest prevalence of O (28.7%). There was a statistically significant better survival (P = 0.04) for blood group O cases than non-O cases among unresected but not among resected patients. Secretor status did not show an association with PDAC or survival. Our study demonstrates that pancreatic cancer risk is influenced by ABO status, in particular blood groups O and A1 , and that this association may reflect also in tumor resectability and survival.

Association between ABO blood types and sporadic pancreatic neuroendocrine tumors in the Chinese Han population

Background

Although the relationship between non-O blood types and the risk of exocrine pancreatic cancer has been demonstrated, the association between ABO blood types and sporadic pancreatic neuroendocrine tumor (PNET) has not been reported thus far.

Methods

This hospital-based, case-control study included 387 patients with PNET and 542 age- and sex-matched controls. Unconditional multivariable logistic regression analysis was performed to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs). The relationship between ABO blood types and clinicopathologic features was also analyzed.

Results

After adjusting for age, sex, smoking status, alcohol drinking, and first-degree family history of any cancer, the AORs (95% CI) of functional PNET were 0.87 (0.59–1.28) for blood type A, 0.86 (0.58–1.28) for blood type B, and 0.71 (0.39–1.26) for blood type AB compared with subjects with blood type O. A similar ABO blood-type distribution was observed among cases with non-functional PNETs compared with controls. On comparing blood type B with non-B blood type, cases with non-functional PNETs had marginally higher rates of lymph node invasion (P = 0.047), distant metastasis (P = 0.044), and advanced European Neuroendocrine Tumor Society Stage (P = 0.040).

Conclusions

There is no association between the ABO blood group and the development of functional and non-functional PNETs. The ABO blood types are not associated with the clinicopathologic features in patients with functional and non-functional PNETs.