Zhang Hao, Qu Mengdi, Sun Caihong, Wang Yanghanzhao, Li Ting, Xu Wei, Sun Zhirong, Zhang Xiaoguang, Guo Kefang, Chen Wankun, Sun Minli, Miao Changhong
Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Perioperative Stress and Protection, Shanghai, China.
Front Oncol. 2022 Jul 7;12:927262. doi: 10.3389/fonc.2022.927262. eCollection 2022.
Opioids are widely used during primary debulking surgery (PDS) for ovarian cancers, and a high mu-opioid receptor (MOR) expression predicts worse cancer outcomes. However, the impact of MOR expression on survival outcomes in ovarian cancers is still not clear.
A retrospective cohort study was conducted in patients who underwent PDS in ovarian cancer patients. MOR expression was measured in tumor and normal tissue. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Secondary outcomes included perineural invasion (PNI), intraoperative sufentanil consumption, length of stay (LOS), and verbal numerical rating scale (VNRS) on postoperative day 1 (POD1), POD3, and POD5.
After propensity score matching, a total of 366 patients were finally enrolled in this study. There were no significant differences in OS rates in patients with high versus low levels of MOR (1-year OS: 82.9% versus 83.3%, 3-year: 57.8% versus 59.1%, 5-year: 22.4% versus 23.1%,respectively) in the ovarian cancers. There were no significant differences in DFS between the groups. Intraoperative sufentanil consumption was higher in the MOR high-expression group compared with the MOR low-expression group. Tumors expressing high levels of MOR showed higher rates of PNI. VNRS in the MOR high-expression group was higher on POD1.
MOR is not an independent predictor of worse survival in ovarian cancers but is associated with high rates of perineural invasion.
阿片类药物在卵巢癌的初次肿瘤细胞减灭术（PDS）中广泛使用，高μ-阿片受体（MOR）表达预示着更差的癌症预后。然而，MOR表达对卵巢癌生存结局的影响仍不明确。
对接受卵巢癌PDS的患者进行回顾性队列研究。在肿瘤组织和正常组织中测量MOR表达。主要结局为总生存期（OS）和无病生存期（DFS）。次要结局包括神经周围侵犯（PNI）、术中舒芬太尼用量、住院时间（LOS）以及术后第1天（POD1）、POD3和POD5的言语数字评定量表（VNRS）。
经过倾向评分匹配后，本研究最终纳入366例患者。卵巢癌患者中，MOR高水平与低水平患者的OS率无显著差异（1年OS：分别为82.9%对83.3%，3年：57.8%对59.1%，5年：22.4%对23.1%）。两组间DFS无显著差异。与MOR低表达组相比，MOR高表达组术中舒芬太尼用量更高。高表达MOR的肿瘤显示出更高的PNI发生率。MOR高表达组在POD1时VNRS更高。
MOR不是卵巢癌生存预后较差的独立预测因素，但与高神经周围侵犯率相关。
