Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea.
Department of Physiology, College of Medicine, Chungnam National University, Daejeon 35015, Korea.
Medicina (Kaunas). 2021 Nov 21;57(11):1280. doi: 10.3390/medicina57111280.
: Propofol-based total intravenous anesthesia (TIVA) is presumed to have more favorable effects on the prognosis of patients with cancer compared with volatile inhaled anesthesia (VIA). We hypothesized that these anesthetics target plasma apurinic apyrimidinic endonuclease/redox effector factor-1 (APE1/Ref-1) as a possible mechanism of action. : The plasma APE1/Ref-1 level was evaluated three times during surgery for cancer, i.e., before anesthesia, immediately after cancer resection, and finally, in the recovery room. Blood (3 cc) was drawn from the radial artery catheter, and plasma APE1/Ref-1 levels were compared according to measurement time and between the two groups. Spearman's Rho correlation analysis was performed to determine relationships among body mass index, American Society of Anesthesiologists classification, age, sex, cancer type, and tumor-node-metastasis (TNM) stage. A total of 166 patients (VIA: 129; TIVA: 37) were enrolled. : Plasma APE1/Ref-1 level increased significantly ( = 0.028) after cancer resection compared with before surgery, but no significant difference was observed between anesthetics ( = 0.134). The post-resection plasma APE1/Ref-1 level showed a positive correlation with the NM stages, but not the T stage. : The plasma APE1/Ref-1 level increased during surgery with more severe lymph node invasion, but there were no significant differences according to the anesthetics used.
基于异丙酚的全静脉麻醉（TIVA）被认为比挥发性吸入麻醉（VIA）对癌症患者的预后有更有利的影响。我们假设这些麻醉剂以血浆脱嘌呤脱嘧啶核酸内切酶/氧化还原效应因子-1（APE1/Ref-1）为作用靶点。
在癌症手术期间，即麻醉前、癌症切除后立即以及最后在恢复室，共三次评估血浆 APE1/Ref-1 水平。从桡动脉导管抽取 3cc 血液，根据测量时间和两组比较血浆 APE1/Ref-1 水平。采用 Spearman's Rho 相关分析确定体重指数、美国麻醉师协会分类、年龄、性别、癌症类型和肿瘤-淋巴结-转移（TNM）分期与 APE1/Ref-1 水平之间的关系。共纳入 166 例患者（VIA：129 例；TIVA：37 例）。
癌症切除后，血浆 APE1/Ref-1 水平显著升高（ = 0.028），与手术前相比，但麻醉之间无显著差异（ = 0.134）。术后血浆 APE1/Ref-1 水平与 NM 分期呈正相关，但与 T 分期无关。
在手术过程中，随着淋巴结侵犯程度的加重，血浆 APE1/Ref-1 水平升高，但根据使用的麻醉剂，没有显著差异。
