Changes in the Plasma Apurinic/Apyrimidinic Endonuclease 1/Redox Factor-1(APE1/Ref-1) Level during Cancer Surgery: An Observational Study

Yumin Jo,Yuran Lee,Insang Song,Eunhye Park,Byeonghwa Jeon,Jiyeon Kim,Chaeseong Lim,Jaesung Lim,Minwoong Kang,Yeojung Kim

doi:10.3390/medicina57111280

Abstract

Background and Objectives: Propofol-based total intravenous anesthesia (TIVA) is presumed to have more favorable effects on the prognosis of patients with cancer compared with volatile inhaled anesthesia (VIA). We hypothesized that these anesthetics target plasma apurinic apyrimidinic endonuclease/redox effector factor-1 (APE1/Ref-1) as a possible mechanism of action. Materials and Methods: The plasma APE1/Ref-1 level was evaluated three times during surgery for cancer, i.e., before anesthesia, immediately after cancer resection, and finally, in the recovery room. Blood (3 cc) was drawn from the radial artery catheter, and plasma APE1/Ref-1 levels were compared according to measurement time and between the two groups. Spearman’s Rho correlation analysis was performed to determine relationships among body mass index, American Society of Anesthesiologists classification, age, sex, cancer type, and tumor-node-metastasis (TNM) stage. A total of 166 patients (VIA: 129; TIVA: 37) were enrolled. Results: Plasma APE1/Ref-1 level increased significantly (p = 0.028) after cancer resection compared with before surgery, but no significant difference was observed between anesthetics (p = 0.134). The post-resection plasma APE1/Ref-1 level showed a positive correlation with the NM stages, but not the T stage. Conclusions: The plasma APE1/Ref-1 level increased during surgery with more severe lymph node invasion, but there were no significant differences according to the anesthetics used.

Highlights

Afterthe theexclusion exclusionofofineligible ineligiblepatient patientsamples, samples, gas anesthesia was performed in patients, and was performed gas anesthesia was performed in 129 patients, and total intravenous anesthesia (TIVA) was performedinin37
Plasma apyrimidinic endonuclease 1 (APE1)/redox effector factor-1 (Ref-1) level increased during surgery but did not differ significantly between the two groups
Plasma APE1/Ref-1 level showed a positive correlation with the degree of lymph node involvement

Summary

Introduction

Propofol-based total intravenous anesthesia (TIVA) helps to preserve immunity more effectively than volatile inhaled anesthesia (VIA) [1,2,3]. Many in vitro studies have shown that the underlying mechanism involves directly targeting the RNA of cancer cells [5]; there have been few in vivo studies, and the results of human studies are inconsistent [6,7]. Propofol-based total intravenous anesthesia (TIVA) is presumed to have more favorable effects on the prognosis of patients with cancer compared with volatile inhaled anesthesia (VIA). We hypothesized that these anesthetics target plasma apurinic apyrimidinic endonuclease/redox effector factor-1 (APE1/Ref-1) as a possible mechanism of action.

Methods

Results

Conclusion