Effect of combined epidural anaesthesia on tumor‐infiltrating lymphocytes in lung adenocarcinoma: a prospective exploratory sub‐analysis

Li, M.‐H.; Xu, Zhen Zhen; Huang, Si; Li, T.; Li, X.‐Y.; Wang, D.‐X.

doi:10.1111/aas.13068

Cited by 8 publications

(7 citation statements)

References 41 publications

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“…TILs could be affected by many factors. There is one study elucidated the epidural anaesthesia could preserves immune function and affect TILs [45]. According to another study, researchers found that tumor areas with CD4+ and CD8+ lymphocytes have a better prognosis [46].…”

Section: Discussionmentioning

confidence: 99%

AURKA and FAM83A are prognostic biomarkers and correlated with Tumor-infiltrating Lymphocytes in smoking related Lung Adenocarcinoma

Zhang¹,

Chen²,

Jiang³

et al. 2021

J. Cancer

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Lung adenocarcinoma (LUAD) has become the main histologic type, which account for nearly 40% of lung cancer. The present study aimed to investigate the gene expression signature in smoking related LUAD. A total of 45 smoking related DEGs in LUAD were identified and functional enrichment analysis was also performed. Then Cox's regression model and Kaplan-Meier analysis were used to screen potential prognostic genes. Finally, AURKA and FAM83A were left for further immune-related mechanism exploration. Kaplan-Meier analysis indicated survival rates are related to different immune cell (B cell and Dendritic cell) infiltration levels. Mechanistically, we further explore the correlation between AURKA and FAM83A gene expression levels and tumor-infiltrating lymphocytes (TILs) level as well as their response to immunomodulators. The results suggested that AURKA and FAM83A are highly expressed in smoking related LUAD, and negatively correlated to B cell and Dendritic cell infiltration levels. At the same time, B cell and Dendritic cell infiltration levels also related to the prognosis of LUAD. We further revealed AURKA and FAM83A could be novel targets to improve the prognosis of LUAD through regulated the response to immunomodulators.

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Section: Discussionmentioning

confidence: 99%

AURKA and FAM83A are prognostic biomarkers and correlated with Tumor-infiltrating Lymphocytes in smoking related Lung Adenocarcinoma

Zhang¹,

Chen²,

Jiang³

et al. 2021

J. Cancer

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“…Perioperative EA was reported to attenuate the immunosuppression by inhibiting the stress responses and/or alleviating the perioperative pain (58). Meanwhile, perioperative EA can improve the function of immunity via preserve and/or increase the numbers of immune cells and reduce the plasma concentrations of immune suppressive soluble factors (61)(62)(63)(64)(65).…”

Section: Perioperative Ea Attenuates Surgical Stress and Painmentioning

confidence: 99%

Effects of Perioperative Epidural Analgesia on Cancer Recurrence and Survival

et al. 2022

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Surgical resection is the main curative avenue for various cancers. Unfortunately, cancer recurrence following surgery is commonly seen, and typically results in refractory disease and death. Currently, there is no consensus whether perioperative epidural analgesia (EA), including intraoperative and postoperative epidural analgesia, is beneficial or harmful on cancer recurrence and survival. Although controversial, mounting evidence from both clinical and animal studies have reported perioperative EA can improve cancer recurrence and survival via many aspects, including modulating the immune/inflammation response and reducing the use of anesthetic agents like inhalation anesthetics and opioids, which are independent risk factors for cancer recurrence. However, these results depend on the cancer types, cancer staging, patients age, opioids use, and the duration of follow-up. This review will summarize the effects of perioperative EA on the oncological outcomes of patients after cancer surgery.

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“…Regarding cellular mechanisms, a prospective randomized analysis of tumour-infiltrating lymphocytes in adenocarcinoma of the lung showed an increased CD8+ lymphocyte subset and a decrease in regulatory T cells in the histology of resected tumours in patients with a combined anaesthesia (general + epidural) in comparison to general anaesthesia alone [ 53 ] (Fig. 1 ).…”

Section: Pain Managementmentioning

confidence: 99%

Anaesthesia as an influence in tumour progression

Plücker

Wirsik

Ritter

et al. 2021

Langenbecks Arch Surg

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Purpose Tumour growth and the formation of metastases are essential elements in the progression of cancer. The centre of treatment is the surgical resection of primary solid tumours. But even if the tumour can be removed without microscopic residual cells, local recurrences and distant metastases occur and determine the patient’s fate. During the operation, tumour cells are shed from the primary tumour and released into the circulation. These circulating tumour cells might play an important role in the formation of new tumour sites. Therefore, a functional innate and adaptive immune system is essential, especially in this perioperative period. Anaesthesia influences consciousness and pain perception and interacts directly with the immune system and tumour cells. Methods Review of the current literature concerning intra- and postoperative anaesthetic decisions and tumour progression. Results There are beneficial aspects for patient survival associated with total intravenous anaesthesia, the use of regional anaesthetics and the avoidance of allogeneic red blood cell transfusions. Alternatives such as irradiated intraoperative blood salvage and preoperative iron supplementation may be advantageous in cases where transfusions are limited or not wanted. The immunosuppressive properties of opioids are theoretical, but strong evidence to avoid them does not exist. The application of nonsteroidal anti-inflammatory drugs and postoperative nausea and vomiting prophylaxis do not impair the patient’s survival and may even have a positive effect on tumour regression. Conclusion Anaesthesia does play an important part in the perioperative period in order to improve the cancer-related outcome. Further research is necessary to make more concrete recommendations.

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Effect of combined epidural anaesthesia on tumor‐infiltrating lymphocytes in lung adenocarcinoma: a prospective exploratory sub‐analysis

Abstract: For patients undergoing surgery for lung adenocarcinoma under general anesthesia, use of epidural anaesthesia increased CD8 T cells infiltration but decreased FOXP3 T cells accumulation in tumor tissues. Epidural anaesthesia may affect TILs in a manner that preserves immune function.

Cited by 8 publications

References 41 publications

AURKA and FAM83A are prognostic biomarkers and correlated with Tumor-infiltrating Lymphocytes in smoking related Lung Adenocarcinoma

AURKA and FAM83A are prognostic biomarkers and correlated with Tumor-infiltrating Lymphocytes in smoking related Lung Adenocarcinoma

Effects of Perioperative Epidural Analgesia on Cancer Recurrence and Survival

Anaesthesia as an influence in tumour progression

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