Grigorios Lyronis, Eleni Efraimidou, Maria-Eleni Zachou, Antigoni Kaprana, Erasmia Xanthopoulou, Alexandra Giatromanolaki, Michael I Koukourakis, Pelagia Chloropoulou
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引用次数: 0
Abstract
Background/aim: The perioperative period may influence immune function in cancer patients, with anesthetic agents potentially contributing to immunosuppression. This study evaluated the differential impact of fentanyl and remifentanil on immune cell populations in breast cancer (BCa) patients undergoing surgery.
Patients and methods: Thirty patients with histologically confirmed BCa who were treated with modified radical mastectomy or breast-conserving surgery followed by radiotherapy were included in the study. Anesthesia was administered using either fentanyl (n=12) or remifentanil (n=18). White blood cell (WBC) and lymphocyte (LC) counts were recorded before and 24 h after surgery. Peripheral blood mononuclear cells were analyzed for T-cell subpopulations using flow cytometry.
Results: WBC counts increased from a median of 7,025/μl before to 10,065/μl after surgery (p<0.0001), whilst LC counts were reduced from a median value of 1,785 to 1,090 (p=0.0002). The median duration of anesthesia was 212 min. Patients who received remifentanil for a shorter anesthesia period (<212 min) experienced a marginal non-significant degree of leukocytosis (p=0.07), while no lymphopenia was evident (p=0.38). In contrast, longer remifentanil exposure significantly induced significant leukocytosis (p=0.01) and lymphopenia (p=0.009), similar to fentanyl. There were no significant differences between fentanyl and remifentanil in their effects on CD4+, CD8+, or CD4+/CD25+/FOXP3+ T-cell populations. Notably, the percentage of CD4+ T-cells was positively correlated with the duration of anesthesia (p=0.002, r=0.53).
Conclusion: Optimizing analgesic selection and anesthesia duration may play a crucial role in minimizing immunosuppressive perioperative stress in patients undergoing BCa surgery. Remifentanil combined with shorter anesthesia exposure appears to mitigate immune suppression, suggesting a potential strategy to preserve immune competence during oncologic surgery.
期刊介绍：
ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed.
ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies).
Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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