School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Curr Oncol Rep. 2022 Oct;24(10):1327-1336. doi: 10.1007/s11912-022-01300-5. Epub 2022 May 28.
The influence of opioids on outcomes after cancer surgery when used, or avoided, intraoperatively remains unclear. There is a need to conduct a scoping review to explore the wider context and provide direction for future research. The review will examine the current state of evidence in humans, with a focus on immunological biomarkers and clinically relevant cancer outcomes in trials comparing opioid-free to opioid-based general anaesthesia.
There is limited research on this subject area, which is mainly focused on breast cancer. The most frequently evaluated immunological parameter is the neutrophil-to-lymphocyte ratio. Cancer outcomes are mainly focused on recurrence. The central knowledge gap is understanding how the cellular effects of opioids translate into longer-term patient outcomes. The major challenge for future research is accounting for the immunomodulatory effects of a wide range of confounding factors, which have yet to be clarified.
在癌症手术后使用或避免使用阿片类药物对手术结果的影响仍不清楚。有必要进行范围综述，以更广泛的背景进行探讨，并为未来的研究提供方向。该综述将检查目前在人类中的证据状况，重点关注免疫生物标志物和比较无阿片类药物与基于阿片类药物的全身麻醉的临床试验中的临床相关癌症结局。
该主题领域的研究有限，主要集中在乳腺癌上。评估最多的免疫参数是中性粒细胞与淋巴细胞比值。癌症结局主要集中在复发上。中心知识空白是了解阿片类药物的细胞作用如何转化为患者的长期结局。未来研究的主要挑战是说明尚未阐明的大量混杂因素的免疫调节作用。
