Key Laboratory for Biotechnology on Medicinal Plants of Jiangsu Province, School of Life Science, Jiangsu Normal University, Xuzhou 221116, P.R. China.
Department of Gynecology and Obstetrics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, P.R. China.
Biosci Rep. 2017 Oct 24;37(5). doi: 10.1042/BSR20170915. Print 2017 Oct 31.
The present study aimed to explore the effects of different anesthetic methods on cellular immune function and prognosis of patients with ovarian cancer (OC) undergoing oophorectomy. A total of 167 patients who received general anesthesia (GA) treatment (GA group) and 154 patients who received combined general/epidural anesthesia (GEA) treatment (GEA group) were collected retrospectively. Each group selected 124 patients that met the inclusion and exclusion criteria for further study. ELISA and radioimmunoassay were employed to detect levels of IL-2, TNF-α, and CA-125. The rates of tumor-red cell rosette (RTRR), red cell immune complex rosette (RRICR), and red cell C3b receptor rosette (RRCR) were also measured. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were determined by hemodynamics. The levels of tumor necrosis factor-α (TNF-α) and interleukin (IL)-2 decreased at 1 h intraoperation (T2), but increased 24-h post surgery (T3). The levels of TNF-α and IL-2 were recovered faster in the GEA group than in the GA group. The GA group exhibited greater levels of CA-125 expression than in the GEA group. The levels of RTRR, RRICR, and RRCR; ratios of CD3, CD4, CD4/CD8, CD16, and CD56 at 30 min after anesthesia (T1), T2, T3 and 48 h after the operation (T4) and levels of SBP, DBP, and HR at T1, T2, and T3 displayed increased levels in the GEA group than in the GA group. At 72-h post surgery (T5), the 5-year survival rate significantly increased in the GEA group compared with the GA group. GEA to be more suitable than GA for surgery on OC patients.
本研究旨在探讨不同麻醉方法对卵巢癌（OC）患者卵巢切除术后细胞免疫功能和预后的影响。回顾性收集了 167 例接受全身麻醉（GA）治疗的患者（GA 组）和 154 例接受全身联合硬膜外麻醉（GEA）治疗的患者（GEA 组）。每组各选取 124 例符合纳入排除标准的患者进行进一步研究。采用酶联免疫吸附试验（ELISA）和放射免疫法检测白细胞介素（IL）-2、肿瘤坏死因子（TNF）-α和 CA-125 水平。检测肿瘤红细胞玫瑰花结（RTRR）、红细胞免疫复合物玫瑰花结（RRICR）和红细胞 C3b 受体玫瑰花结（RRCR）的形成率。采用血流动力学检测收缩压（SBP）、舒张压（DBP）和心率（HR）。手术中 1 小时（T2）时 TNF-α和 IL-2 水平下降，但术后 24 小时（T3）时升高。与 GA 组相比，GEA 组 TNF-α和 IL-2 水平恢复更快。GA 组 CA-125 表达水平高于 GEA 组。麻醉后 30 分钟（T1）、T2、T3 和术后 48 小时（T4）时，RTRR、RRICR 和 RRCR；CD3、CD4、CD4/CD8、CD16 和 CD56 的比值；T1、T2 和 T3 时的 SBP、DBP 和 HR 水平在 GEA 组均升高。术后 72 小时（T5）时，GEA 组 5 年生存率明显高于 GA 组。与 GA 相比，GEA 更适合 OC 患者的手术。
