Comparison of effects of different anesthetic and postoperative analgesic methods on immune function of helper T lymphocytes and tumor metastasis after orthotopic liver cancer resection in rats
10.3760/cma.j.issn.0254-1416.2014.01.006
- VernacularTitle:不同麻醉和术后镇痛方法对大鼠原位肝癌切除术后辅助性T淋巴细胞免疫功能和肿瘤转移影响的比较
- Author:
Di ZHOU
;
Lanfang ZHU
;
Changhong MIAO
- Publication Type:Journal Article
- Keywords:
Anesthesia,general;
Anesthesia,epidural;
Analgesia;
Liver neoplasms;
Hepatectomy;
CD4-positive T-lymphocytes;
Immunity,cellular;
Neoplasm metastasis
- From:
Chinese Journal of Anesthesiology
2014;34(1):19-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects of different anesthetic and postoperative analgesic methods on the immune function of helper T lymphocytes and tumor metastasis after orthotopic liver cancer resection in rats.Methods Orthotopic liver cancer was induced by intrahepatic tumor implantation (IHTI) with Morris hepatoma 3924A.Thirty male ACI rats receiving IHTI,aged 12-18 weeks,weighing 240-300 g,were randomized into 3 groups (n =10 each) using a random number table:control group (group C),general anesthesia combined with epidural block-postoperative epidural analgesia group (group GE + EA),and general anesthesia-postoperative intravenous analgesia group (group G + IA).The liver cancer resection was performed on 14th day after IHTI,group G + IA inhaled 5％ sevoflurane for induction of anesthesia and inhaled 2％-3％ sevoflurane and received intraperitoneal injection of morphine 20 μg/100 g for maintenance of anesthesia.In group GE + EA,general anesthesia was performed as the method previously described in group G + IA,and epidural block was performed with 0.25 ％ bupivacaine 25 μl after tracheal intubation.Within 3 days after operation,0.125 ％ bupivacaine 150 μl + morphine 20 μg were injected daily via an epidural catheter once every 4 h (25μl per time) for postoperative analgesia in group GE + EA,and postoperative analgesia was performed with intraperitoneal morphine 240 μg injected daily once every 4 h (40 μg per time) in group G+ IA.Before surgery (T1) and on 2nd,7th and 30th days after sugery (T2-4),blood samples were collected to detect the levels of plasma interferon-γ (IFN-γ),interleukin-4 (IL-4),IL-17,IL-10 and tumor growth factor-β1 (TGF-β1).IFN-γ/IL-4 ratio was calculated.The rats were sacrificed after collecting blood samples at T4,and the development of abdominal lymph node metastasis,malignant ascites,implantation metastasis to abdominal wall and visible pulmonary metastasis nodules were observed.Results Compared with C group,the incidence of pulmonary metastasis,abdominal lymph node metastasis,and malignant ascites was significantly decreased,the plasma IFN-γ and IL-17 levels at T2 and IL-4 and TGF-β at T2,3 were increased,and IFN-γ/IL-4 ratio was decreased at T2,3 in group G+ IA,and the incidence of pulmonary metastasis,abdominal lymph node metastasis,malignant ascites and implantation metastasis to abdominal wall was significantly decreased,the plasma levels of IFN-γ,IL-4,IL-17,IL-10 and TGF-β1 were increased at T2(P ＜ 0.05),and no significant change was found in IFN-γ/IL-4 ratio in GE + EA group (P ＞ 0.05).Compared with G + IA group,the incidence of pulmonary metastasis and abdominal lymph node metastasis was significantly decreased,the plasma levels of IFN-γ and IL-17 at T2 and IL-4 and IL-10 at T3 were decreased,the plasma levels of IFN-γ at T4 and TGF-β1 at T2 and IFN-γ/IL-4 ratio at T3,4 were increased in GE + EA group (P ＜ 0.05).Conclusion The inhibitory degree of the immune function of helper T lymphocytes is decreased and development of tumor metastasis is reduced after orthotopic liver cancer resection in rats when general anesthesia combined with epidural block-postoperative epidural analgesia is applied as compared with those when general anesthesia-postoperative intravenous analgesia is applied.
