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Abstract：
BACKGROUND: Anesthesia techniques and drug selection may influence tumor recurrence and metastasis. Neutrophil extracellular trapping (NETosis), an immunological process, has been linked to an increased susceptibility to metastasis in individuals with tumors. Furthermore, recurrence may be associated with vascular endothelial growth factor A (VEGF-A), a mediator of angiogenesis. This study investigates the impact of lidocaine (combined with sevoflurane or propofol anesthesia ) during breast cancer surgery inhibits the expression of biomarkers associated with metastasis and recurrence (specifically H3Cit, NE, MPO, MMP-9 and VEGF-A).
METHODS: We randomly assigned 120 women undergoing primary or invasive breast tumor resection to receive one of four anesthetics: sevoflurane (S), sevoflurane plus i.v. lidocaine (SL), propofol (P), and propofol plus i.v. lidocaine (PL). Blood samples were collected before induction and 3 h after the operation. Biomarkers associated with NETosis (citrullinated histone H3 [H3Cit], myeloperoxidase [MPO], and neutrophil elastase [NE]) and angiogenesis were quantified using enzyme-linked immunosorbent assays.
RESULTS: Patient and breast tumor characteristics, along with perioperative management, did not differ between study groups. In intra-group comparisons, S and P groups demonstrated a statistically significant increase in post-operative MPO (S group: 10.39[6.89-17.22] vs. 14.31[8.55-20.87] ng ml-1, P = 0.032; P group: 9.45[6.73-17.37] vs. 14.34[9.87-19.75] ng ml-1, P = 0.035)and NE(S group: 182.70[85.66-285.85] vs. 226.20[91.85-391.65] ng ml-1, P = 0.045; P group: 154.22[97.31-325.30] vs. 308.66[132.36-483.57] ng ml-1, P = 0.037) concentrations compared to pre-operative measurements, whereas SL and PL groups did not display a similar increase. H3Cit, MMP-9, and VEGF-A concentrations were not significantly influenced by the anesthesia techniques and drugs.
CONCLUSIONS: Regardless of the specific technique employed for general anesthesia, there was no increase in the postoperative serum concentrations of MPO and NE after perioperative lidocaine infusion compared to preoperative serum concentrations. This supports the hypothesis that intravenous lidocaine during cancer surgery aimed at achieving a cure may potentially decrease the likelihood of recurrence. Further interpretation and discussion of clinical implications are warranted, emphasizing the significance of these findings in the context of cancer surgery and recurrence prevention.
BACKGROUND: ChiCTR2300068563.
METHODS: We randomly assigned 120 women undergoing primary or invasive breast tumor resection to receive one of four anesthetics: sevoflurane (S), sevoflurane plus i.v. lidocaine (SL), propofol (P), and propofol plus i.v. lidocaine (PL). Blood samples were collected before induction and 3 h after the operation. Biomarkers associated with NETosis (citrullinated histone H3 [H3Cit], myeloperoxidase [MPO], and neutrophil elastase [NE]) and angiogenesis were quantified using enzyme-linked immunosorbent assays.
RESULTS: Patient and breast tumor characteristics, along with perioperative management, did not differ between study groups. In intra-group comparisons, S and P groups demonstrated a statistically significant increase in post-operative MPO (S group: 10.39[6.89-17.22] vs. 14.31[8.55-20.87] ng ml-1, P = 0.032; P group: 9.45[6.73-17.37] vs. 14.34[9.87-19.75] ng ml-1, P = 0.035)and NE(S group: 182.70[85.66-285.85] vs. 226.20[91.85-391.65] ng ml-1, P = 0.045; P group: 154.22[97.31-325.30] vs. 308.66[132.36-483.57] ng ml-1, P = 0.037) concentrations compared to pre-operative measurements, whereas SL and PL groups did not display a similar increase. H3Cit, MMP-9, and VEGF-A concentrations were not significantly influenced by the anesthesia techniques and drugs.
CONCLUSIONS: Regardless of the specific technique employed for general anesthesia, there was no increase in the postoperative serum concentrations of MPO and NE after perioperative lidocaine infusion compared to preoperative serum concentrations. This supports the hypothesis that intravenous lidocaine during cancer surgery aimed at achieving a cure may potentially decrease the likelihood of recurrence. Further interpretation and discussion of clinical implications are warranted, emphasizing the significance of these findings in the context of cancer surgery and recurrence prevention.
BACKGROUND: ChiCTR2300068563.
摘要：
背景：麻醉技术和药物选择可能影响肿瘤的复发和转移。中性粒细胞胞外捕获（NETosis），免疫过程，与肿瘤患者对转移的易感性增加有关。此外，复发可能与血管内皮生长因子A（VEGF-A）有关，血管生成的介质。这项研究调查了利多卡因（联合七氟醚或丙泊酚麻醉）在乳腺癌手术期间抑制与转移和复发相关的生物标志物表达的影响（特别是H3Cit，NE,MPO,MMP-9和VEGF-A)。
方法：我们随机分配了120名接受原发性或浸润性乳腺肿瘤切除术的妇女，接受四种麻醉药之一：七氟醚（S），七氟醚加静脉注射利多卡因（SL），异丙酚(P),和异丙酚加静脉注射利多卡因（PL）。在诱导前和手术后3小时收集血样。与NETosis相关的生物标志物(瓜氨酸化组蛋白H3[H3Cit]，髓过氧化物酶和中性粒细胞弹性蛋白酶[NE]）和血管生成使用酶联免疫吸附测定进行定量。
结果：患者和乳腺肿瘤特征，随着围手术期管理，研究组之间没有差异。在组内比较中，S和P组显示术后MPO的统计学显着增加（S组：10.39[6.89-17.22]vs.14.31[8.55-20.87]ngml-1，P=0.032；P组：9.45[6.73-17.37]vs.14.34[9.87-19.75]ngml-1，P=0.035）和NE（S组：182.70[85.66-285.85]vs.226.20[91.85-391.65]ngml-1，P=0.045；P组：154.22[97.31-325.30]vs.308.66[132.36-483.57]ngml-1，P=0.037）与术前测量相比的浓度，而SL和PL组没有显示出类似的增加。H3Cit,麻醉技术和药物对MMP-9和VEGF-A的浓度没有显着影响。
结论：无论全身麻醉采用何种具体技术，与术前血清浓度相比,围手术期输注利多卡因后MPO和NE的术后血清浓度没有升高.这支持以下假设：旨在实现治愈的癌症手术期间静脉注射利多卡因可能会降低复发的可能性。有必要对临床意义进行进一步的解释和讨论，强调这些发现在癌症手术和预防复发方面的重要性。
背景：ChiCTR2300068563。
方法：我们随机分配了120名接受原发性或浸润性乳腺肿瘤切除术的妇女，接受四种麻醉药之一：七氟醚（S），七氟醚加静脉注射利多卡因（SL），异丙酚(P),和异丙酚加静脉注射利多卡因（PL）。在诱导前和手术后3小时收集血样。与NETosis相关的生物标志物(瓜氨酸化组蛋白H3[H3Cit]，髓过氧化物酶和中性粒细胞弹性蛋白酶[NE]）和血管生成使用酶联免疫吸附测定进行定量。
结果：患者和乳腺肿瘤特征，随着围手术期管理，研究组之间没有差异。在组内比较中，S和P组显示术后MPO的统计学显着增加（S组：10.39[6.89-17.22]vs.14.31[8.55-20.87]ngml-1，P=0.032；P组：9.45[6.73-17.37]vs.14.34[9.87-19.75]ngml-1，P=0.035）和NE（S组：182.70[85.66-285.85]vs.226.20[91.85-391.65]ngml-1，P=0.045；P组：154.22[97.31-325.30]vs.308.66[132.36-483.57]ngml-1，P=0.037）与术前测量相比的浓度，而SL和PL组没有显示出类似的增加。H3Cit,麻醉技术和药物对MMP-9和VEGF-A的浓度没有显着影响。
结论：无论全身麻醉采用何种具体技术，与术前血清浓度相比,围手术期输注利多卡因后MPO和NE的术后血清浓度没有升高.这支持以下假设：旨在实现治愈的癌症手术期间静脉注射利多卡因可能会降低复发的可能性。有必要对临床意义进行进一步的解释和讨论，强调这些发现在癌症手术和预防复发方面的重要性。
背景：ChiCTR2300068563。
