Zhou Xueliang, Shao Yanfei, Li Shuchun, Zhang Sen, Ding Chengsheng, Zhuang Lei, Sun Jing
Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Pharmacol. 2022 Nov 25;13:1057571. doi: 10.3389/fphar.2022.1057571. eCollection 2022.
Malignant tumors are the second leading cause of death worldwide. This is a public health concern that negatively impacts human health and poses a threat to the safety of life. Although there are several treatment approaches for malignant tumors, surgical resection remains the primary and direct treatment for malignant solid tumors. Anesthesia is an integral part of the operation process. Different anesthesia techniques and drugs have different effects on the operation and the postoperative prognosis. Propofol is an intravenous anesthetic that is commonly used in surgery. A substantial number of studies have shown that propofol participates in the pathophysiological process related to malignant tumors and affects the occurrence and development of malignant tumors, including anti-tumor effect, pro-tumor effect, and regulation of drug resistance. Propofol can also reshape the tumor microenvironment, including anti-angiogenesis, regulation of immunity, reduction of inflammation and remodeling of the extracellular matrix. Furthermore, most clinical studies have also indicated that propofol may contribute to a better postoperative outcome in some malignant tumor surgeries. Therefore, the author reviewed the chemical properties, pharmacokinetics, clinical application and limitations, mechanism of influencing the biological characteristics of malignant tumors and reshaping the tumor microenvironment, studies of propofol in animal tumor models and its relationship with postoperative prognosis of propofol in combination with the relevant literature in recent years, to lay a foundation for further study on the correlation between propofol and malignant tumor and provide theoretical guidance for the selection of anesthetics in malignant tumor surgery.
恶性肿瘤是全球第二大死因。这是一个公共卫生问题,对人类健康产生负面影响,并对生命安全构成威胁。尽管恶性肿瘤有多种治疗方法,但手术切除仍然是恶性实体瘤的主要直接治疗方法。麻醉是手术过程中不可或缺的一部分。不同的麻醉技术和药物对手术及术后预后有不同影响。丙泊酚是一种常用于手术的静脉麻醉剂。大量研究表明,丙泊酚参与与恶性肿瘤相关的病理生理过程,影响恶性肿瘤的发生发展,包括抗肿瘤作用、促肿瘤作用以及耐药性调节。丙泊酚还可重塑肿瘤微环境,包括抗血管生成、免疫调节、减轻炎症和细胞外基质重塑。此外,大多数临床研究也表明,丙泊酚在某些恶性肿瘤手术中可能有助于获得更好的术后结果。因此,作者结合近年来的相关文献,对丙泊酚的化学性质、药代动力学、临床应用及局限性、影响恶性肿瘤生物学特性和重塑肿瘤微环境的机制、丙泊酚在动物肿瘤模型中的研究及其与术后预后的关系进行综述,为进一步研究丙泊酚与恶性肿瘤的相关性奠定基础,并为恶性肿瘤手术中麻醉药物的选择提供理论指导。