丙泊酚和七氟醚对乳腺癌⼿术患者肿瘤细 胞、⾃然杀伤细胞和细胞毒性T淋巴细胞功能的 影响：体外研究
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
The effect of propofol and sevoflurane on cancer cell, natural killer cell, and cytotoxic T lymphocyte function in patients undergoing breast cancer surgery: an in vitro analysis
背景与目的
为了阐明麻醉药物对肿瘤免疫功能的影响，我们观察了丙泊酚和七氟醚对乳腺癌⼿术患者癌细胞和免疫细胞共同培养后⾃然杀伤(NK)细胞、细胞毒性T淋巴细胞(CTL)计数和细胞凋亡率的影响。
方 法
对接受乳腺癌⼿术的患者在麻醉诱导后及术后1、24 h采集静脉⾎。将患者随机分为丙泊酚麻醉组和七氟醚麻醉组。我们⽤与乳腺癌细胞共培养的⽅法，对两组患者的癌细胞、NK细胞和CTL细胞凋亡进⾏了计数和检测。我们还观察了肿瘤坏死因⼦-α、⽩细胞介素-6和⽩细胞介素-10在围⼿术期的变化。
结 果
最终的分析共包括44例患者，两实验组间NK细胞计数、CTL计数及凋亡率⽆明显差异。此外，在乳腺癌细胞共培养过程中，乳腺癌细胞凋亡的数量在两组间⽆显著差异。其次，各组间未检测到细胞因⼦的变化。
结 论
虽然基础科学研究已经表明丙泊酚在癌症⼿术中可能优于挥发性药物，但在NK细胞和CTL细胞计数和包括乳腺癌细胞在内的细胞凋亡率⽅⾯，丙泊酚在乳腺癌⼿术麻醉过程中的作⽤并不优于七氟醚。
原始文献摘要
Lim JA, Oh CS, Yoon T G, Lee JY,et al. The eff ect of propofol and sevoflurane on cancer cell, natural killer cell, and cytotoxic T lymphocyte function in patients undergoing breast cancer surgery: an in vitro analysis.[J]. BMC Cancer 2018 02 07 ;18(1) Randomized Controlled Trial,Research Support , Non-U.S. Gov't DOI：10.1186/s12885-018-4064-8
Background: To clarify the effect of anaesthetic agents on cancer immunity, we evaluated the effects of propof ol and sevoflurane on natural killer (NK) cell, cytotoxic T lymphocyte (CTL) counts and apoptosis rate in breast cancer and immune cells co-cultures from patients who underwent breast cancer surgery.
Methods: Venous blood samples were collected after inducing anaesthesia and at 1 and 24 h postoperatively in patients who had undergone breast cancer surgery. The patients were allocated randomly to the propofol- or sevoflurane-based anaesthesia groups.We counted and detected apoptosis in cancer cell, NK cell and CTL of patients with breast cancer by co-culture with a breast cancer cellline in both groups. We also evaluated changes in the cytokines tumour necrosis f actor-alpha, interleukin (IL)-6 and IL-10 during the perioperative period.
Results: Forty-four patients were included in the final analysis. No difference in NK cell count, CTL count or apoptosis rate was detected between the groups. Furthermore, the number of breast cancer cells undergoing apoptosis in the breast cancer cell cocultures was not diff erent between the groups. No changes in cytokines were detected between the groups.
Conclusion: Although basic science studies have suggested the potential benefits of propofol over a volatile agent during cancer surgery, propofol was not superior to sevoflurane, on the aspects of NK and CTL cells counts with apoptosis rate including breast cancer cell, during anaesthesia f or breast cancer surgery in a clinical environment.
麻醉学文献进展分享
贵州医科大学高鸿教授课题组
编辑：王贵龙 审校：李华宇