Differential effects of serum from patients administered distinct anaesthetic techniques on apoptosis in breast cancer cells in vitro: a pilot study
Differential effects of serum from patients administered distinct anaesthetic techniques on apoptosis in breast cancer cells in vitro: a pilot study
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DOI：
10.1093/bja/aet581
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发表时间：
2014-07-01
影响因子：
9.8
通讯作者：
Buggy, D. J.
中科院分区：
文献类型：
--
作者：
Jaura, A. I.;Flood, G.;Buggy, D. J.
体外和回顾性临床研究表明，在原发性乳腺癌手术麻醉技术和癌症预后之间的关联。细胞凋亡是乳腺癌转移机制中的一个重要环节，但是否受到麻醉技术的影响尚不清楚。本研究利用随机接受不同麻醉方法的乳腺癌手术患者血清，在体外研究其对雌激素受体（ER）阴性乳腺癌细胞凋亡的影响。在一项正在进行的前瞻性临床试验（NCT 00418457）中，活检证实的乳腺癌妇女随机接受丙泊酚全麻加椎旁镇痛（PPA）或标准七氟烷全麻加阿片类镇痛（SGA）。随机选择这些患者（10名PPA和10名SGA）的血清，在麻醉诱导前立即和手术后1小时捐献20毫升静脉血，暴露于er阴性的MDA-MB-231细胞。采用ApoLive-Glo Multiplex Assay （TM）检测细胞凋亡。PPA患者术后血清暴露MDA-MB-231细胞的发光比（凋亡）高于SGA患者，中位数分别为0.40（25-75%）和0.40(0.35-0.43)，中位数分别为0.22 (0.21-0.30)（P=0.001）。SGA术后血清发光比术前降低0.22(0.21-0.30)，术前降低0.3 (0.25-0.35)（P=0.045）。接受七氟醚麻醉和阿片类药物的原发性乳腺癌手术患者的血清比接受异丙酚-椎旁麻醉的患者的血清更能减少er阴性乳腺癌细胞的凋亡。麻醉技术可能以影响癌细胞凋亡的方式影响血清环境，从而影响肿瘤转移。
In vitro and retrospective clinical studies suggest an association between anaesthetic technique during primary breast cancer surgery and cancer outcome. Apoptosis is an important step in the mechanism of breast cancer metastasis, but whether it is influenced by anaesthetic technique is unknown. Using serum from breast cancer surgery patients randomized to receive distinct anaesthetic techniques, we investigated its effect on apoptosis in oestrogen receptor (ER)-negative breast cancer cells in vitro.Women with biopsy-proven breast cancer were randomized to receive either propofol general anaesthesia with paravertebral analgesia (PPA) or standard sevoflurane general anaesthesia with opioid analgesia (SGA) in an ongoing, prospective clinical trial (NCT 00418457). Serum from a randomly selected subset of these patients (10 PPA and 10 SGA) who had donated 20 ml venous blood immediately before anaesthetic induction and at 1 h after operation was exposed to ER-negative MDA-MB-231 cells. Apoptosis was measured using ApoLive-Glo Multiplex Assay (TM).Exposure of MDA-MB-231 cells to postoperative serum of PPA patients resulted in higher luminescence ratio (apoptosis) than SGA patients, median (25-75%), 0.40 (0.35-0.43) compared with 0.22 (0.21-0.30), respectively (P=0.001). The luminescence ratio of postoperative serum from SGA was reduced compared with preoperative SGA 0.22 (0.21-0.30) compared with 0.3 (0.25-0.35) (P=0.045).Serum from patients given sevoflurane anaesthesia and opioids for primary breast cancer surgery reduces apoptosis in ER-negative breast cancer cells to a greater extent than serum from patients given propofol-paravertebral anaesthesia. Anaesthetic technique might affect the serum milieu in a manner that impacts cancer cell apoptosis, and thereby tumour metastasis.