Abstract
BackgroundTo clarify the effect of anaesthetic agents on cancer immunity, we evaluated the effects of propofol 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.MethodsVenous 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 cell line in both groups. We also evaluated changes in the cytokines tumour necrosis factor-alpha, interleukin (IL)-6 and IL-10 during the perioperative period.ResultsForty-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 co-cultures was not different between the groups. No changes in cytokines were detected between the groups.ConclusionAlthough 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 for breast cancer surgery in a clinical environment.Trial registrationNCT02758249 on February 26, 2016.
Highlights
To clarify the effect of anaesthetic agents on cancer immunity, we evaluated the effects of propofol 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
Numerous studies have demonstrated the superiority of propofol over volatile agents, because propofol does not suppress the immune system in a cancerous environment [9,10,11,12,13]
It is difficult to ascertain the true effect of propofol and volatile agents on cancer immunity in a ‘clinical condition’ because various factors, such as surgical stimulation, pain, and drugs can influence the immune system during cancer surgery [1]
Summary
To clarify the effect of anaesthetic agents on cancer immunity, we evaluated the effects of propofol 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. Numerous studies have demonstrated the superiority of propofol over volatile agents, because propofol does not suppress the immune system in a cancerous environment [9,10,11,12,13]. Recent studies have demonstrated conflicting results and did not show any definite effects of anaesthetic agents on cancer immunity. It is difficult to ascertain the true effect of propofol and volatile agents on cancer immunity in a ‘clinical condition’ because various factors, such as surgical stimulation, pain, and drugs can influence the immune system during cancer surgery [1]. Most reviews on anaesthetics and cancer immunity have suggested the need for a clinical prospective study to confirm the superiority of propofol over volatile agents during anaesthesia for cancer surgery
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