Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
The University of Texas Health Science Center at Tyler School of Medicine, TX, USA.
Pharmacol Ther. 2024 Jul;259:108654. doi: 10.1016/j.pharmthera.2024.108654. Epub 2024 May 1.
Since its development in 1943, lidocaine has been one of the most commonly used local anesthesia agents for surgical procedures. Lidocaine alters neuronal signal transmission by prolonging the inactivation of fast voltage-gated sodium channels in the cell membrane of neurons, which are responsible for action potential propagation. Recently, it has attracted attention due to emerging evidence suggesting its potential antitumor properties, particularly in the in vitro setting. Further, local administration of lidocaine around the tumor immediately prior to surgical removal has been shown to improve overall survival in breast cancer patients. However, the exact mechanisms driving these antitumor effects remain largely unclear. In this article, we will review the existing literature on the mechanism of lidocaine as a local anesthetic, its effects on the cancer cells and the tumor microenvironment, involved pathways, and cancer progression. Additionally, we will explore recent reports highlighting its impact on clinical outcomes in cancer patients. Taken together, there remains significant ambiguity surrounding lidocaine's functions and roles in cancer biology, particularly in perioperative setting.
自 1943 年开发以来，利多卡因一直是最常用于外科手术的局部麻醉剂之一。利多卡因通过延长神经元细胞膜上快速电压门控钠离子通道的失活来改变神经元信号传递，该通道负责动作电位的传播。最近，由于有新的证据表明其具有潜在的抗肿瘤特性，特别是在体外环境中，它引起了人们的关注。此外，在手术切除前立即在肿瘤周围局部给予利多卡因已被证明可改善乳腺癌患者的总生存率。然而，驱动这些抗肿瘤作用的确切机制在很大程度上仍不清楚。在本文中，我们将回顾利多卡因作为局部麻醉剂的作用机制、其对癌细胞和肿瘤微环境的影响、涉及的途径以及癌症进展的现有文献。此外，我们将探讨最近的报告，强调其对癌症患者临床结果的影响。总的来说，利多卡因在癌症生物学中的功能和作用，特别是在围手术期，仍然存在很大的不确定性。
