Relationship between Anesthesia and Tumor: Can the Anesthesia affect the Prognosis of the Tumor?

Abstract

The literature has showed propofol can inhibit tumor cell invasion, proliferation and metastasis (mice showed that propofol play an anti-metastasis role in tumor) [1][2][3][4][5][6][7][8][9][10]. Propofol can also make cancer cell apoptosis in non-small cell lung cancer, colon cancer and ovarian [11]. The adhesion of propofol conjugates are inhibited the breast cancer cell migration and promoting apoptosis of cancer cells [12]. The present research showed that propofol may has less impact on the tumor metastasis mechanism and it had no obvious effect on the activity of NK cells but enhance the function of T cells in immune suppression effect during anesthesia. Propofol was found to inhibit hypoxia inducible factor in prostate cancer, so as to reduce stress damage during anesthesia [13,14]. Other studies have indicated that propofol can inhibit the function of neutrophils, monocytes and macrophages in the innate immune response, as well as the inhibition of B lymphocytes in critically ill patients [15,16]. The study also showed that propofol can increase the ratio of Thl/Th2 in PBMCs, it maintain the cell-mediated immune effect, which is beneficial for patients with immune dysfunction.In a rat experimental, thiopentone and ketamine can promote the growth of implanted tumor cells and inhibit the activity of NK cells. However, propofol has played the protective effect. Ketamine mostly used in pediatric anesthesia, in vitro studies have found that ketamine can suppress neutrophil adhesion molecules on the surface and the production of oxygen free radicals, inhibit monocytes catalysis and through the mitochondrial pathway induced apoptosis of T lymphocytes [17,18]. Research about midazolam on tumor prognosis is not many, and that have no reference significance here. Opioid DrugsDuring the perioperative period, opioid drugs can affect the activity of NK cells and macrophages, inhibit the production of immune factors, so as to play a role in inhibiting immune defense function and promoting tumor recurrence and migration [19,20]. Opioids also play a role in the treatment of chronic pain. Opioid antagonist naloxone can inhibit NK cytotoxicity, lymphocyte proliferation, reduces the INF-r that caused by lower abdominal surgery which means cell immunosuppression and opioid peptides and their receptors are closely related. Studies have showed that fentanyl inhibits the immune func- AbstractNowadays, cancer is still one of the most common reasons of death in the world. Surgery as the main treatment for some potentially treatable solid tumors. However, tumor metastasis is the most important cause of death in patients with these tumors. Clinical studies have found that surgery is an influence factor on tumor metastasis. In the perioperative period, the small residual lesions can be killed by the immune system, while it may also escape from the immune attack and then becoming the source of tumor metastasis and recurrence. Anesthesia covers the whole perioperative period, the effect on the patient's immune function mainly in the ...