Effects of serum from breast cancer surgery patients receiving perioperative dexmedetomidine on breast cancer cell malignancy: A prospective randomized controlled trial.

Yan Liu,Jinsong Lu,Tong Wu,Xiaoying Lu,Jiaxin Sun,Hongwei Duan,Jie Tian,Yueyao Du,Diansan Su,Weifeng Yu

doi:10.1002/cam4.2654

Yan Liu, Jinsong Lu + Show 8 more

Open Access

https://doi.org/10.1002/cam4.2654

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Abstract

Adrenergic receptors (ARs) have gained attention for their involvement in breast cancer (BC) progression. Dexmedetomidine, a selective α2‐AR agonist, has been reported to increase the malignancy of BC cells in vitro or stimulate tumor growth in mice. However, clinical evidence is lacking. Clinical research in this area is important as dexmedetomidine is widely used in BC surgery patients. Here we allocated 24 women with primary BC to the dexmedetomidine group (who received a total dose of 2 μg kg−1 dexmedetomidine perioperatively) or to the control group (who received the same volume of normal saline). Venous blood was obtained from all patients immediately upon entering the operating room and 24 hours postoperatively. Serum was then exposed to MCF‐7 cells at a concentration of 10% for 24 hours. Cell proliferation, migration, and invasion were analyzed using EdU, Transwell, and Matrigel methods, respectively. We found that postoperative serum from those who received dexmedetomidine was associated with significantly increased cell proliferation, migration, and invasion compared with preoperative serum when used to culture MCF‐7 cells. The mean percentage change from post to preoperative values in these cell functions was significantly larger in the dexmedetomidine group than in the control group (proliferation, 30.44% vs 8.45%, P = .0024; migration, 15.90% vs 3.25%, P = .0015; invasion, 8.17% vs 2.13%, P = .04). In conclusion, these findings suggest that in patients undergoing surgery for primary BC, perioperative administration of dexmedetomidine might influence the serum milieu in a way that favors the malignancy of MCF‐7 cells.Clinical trial registration: NCT03108937.

Highlights

Breast cancer (BC) is one of the most common tumors among females, which affects about 12% of women worldwide.[1]
Female patients undergoing simple mastectomy combined with sentinel lymph node biopsy or modified radical mastectomy (Auchincloss method) for biopsy‐proven primary BC were enrolled in the study
In this prospective, randomized, and controlled clinical trial recruiting patients undergoing surgery for primary BC, postoperative serum from those who received Dex administration during surgery was associated with significantly increased cell proliferation, migration, and invasion compared with preoperative serum when used to culture BC cell line MCF‐7

Summary

| INTRODUCTION

Breast cancer (BC) is one of the most common tumors among females, which affects about 12% of women worldwide.[1]. In in vitro studies, cell proliferation and migration capacity are increased when mammary tumor cells are treated with specific α2‐AR agonists, such as clonidine.[4,8]. Dexmedetomidine (Dex) is a highly selective α2‐AR agonist with sedative, analgesic, and anesthetic properties. It is widely used in the ICU and anesthesia department due to its unique ability of inducing a calm state with no respiration depression. Several laboratory studies have shown that stimulation by Dex increases BC cell proliferation and migration and tumor growth.[10-12]. Our results demonstrate that in patients undergoing BC surgery, perioperative utilization of Dex may influence the serum milieu in a way that favors the malignancy of MCF‐7 cells

| Study design and patients

| Procedures

| RESULTS

| DISCUSSION

Findings

CONFLICT OF INTEREST