AIM:To investigate the impact of different anesthetic techniques on T-helper(Th) cell subsets in hepatocellular carcinoma(HCC) patients undergoing hepatectomy.METHODS:Sixty-one HCC patients who received hepatectomies ...AIM:To investigate the impact of different anesthetic techniques on T-helper(Th) cell subsets in hepatocellular carcinoma(HCC) patients undergoing hepatectomy.METHODS:Sixty-one HCC patients who received hepatectomies were randomized into an epidural combined general anesthesia(G + E;n = 31) or a general anesthesia(G;n = 30) group.Blood samples were obtained the morning before the operation(d0),and on the second(d2) and seventh(d7) day after the operation.Th cell contents were evaluated using flow cytometry,realtime reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay.RESULTS:In all 61 patients,Th1 and Th2 cell frequencies,and interferon-(IFN-) mRNA expression markedly increased on d2,compared to d0.They recovered slightly on d7,and the Th1/Th2 ratio increased markedly on d7,compared with d2.In contrast,Th17,regulatory T cell(Treg),and interleukin-17(IL-17) levels and FOXP3 mRNA expression showed no significant change on d2,and then markedly decreased on d7.Similarly,plasma IFN-concentration on d2 was much higher than that on d0,and then partly recovered on d7.As compared with the G group,in the G + E group,Th1 cell frequencies and the Th1/Th2 ratio were slightly higher on d2 and significantly higher on d7,while Th2,Th17,and Treg cell frequencies were slightly lower on d2,and significantly lower on d7.Consistently,on d7,IFN-mRNA and protein levels and the IFN-/IL-4 ratio in the G + E group were higher than those in the G group.In contrast,the IL-17 mRNA level,and IL-17 and transforming growth factor-1 concentrations in the G + E group were lower than those in the G group.CONCLUSION:G + E is superior to G in shifting the Th1/Th2 balance towards Th1,while decreasing Th17 and Treg,potentially benefiting HCC patients by promoting anti-tumor Th polarization.展开更多
基金Supported by The State 863 High Technology R and D Project of China,No.2007AA02Z479National Natural Science Foundation of China,No.30972949+3 种基金Shanghai Rising-Star Program, No.10QA1401300FANEDD,No.201183Science and Technology Commission of Shanghai Municipality,No.114119a4400Shanghai "Chen Guang" Project,No.11CG02
文摘AIM:To investigate the impact of different anesthetic techniques on T-helper(Th) cell subsets in hepatocellular carcinoma(HCC) patients undergoing hepatectomy.METHODS:Sixty-one HCC patients who received hepatectomies were randomized into an epidural combined general anesthesia(G + E;n = 31) or a general anesthesia(G;n = 30) group.Blood samples were obtained the morning before the operation(d0),and on the second(d2) and seventh(d7) day after the operation.Th cell contents were evaluated using flow cytometry,realtime reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay.RESULTS:In all 61 patients,Th1 and Th2 cell frequencies,and interferon-(IFN-) mRNA expression markedly increased on d2,compared to d0.They recovered slightly on d7,and the Th1/Th2 ratio increased markedly on d7,compared with d2.In contrast,Th17,regulatory T cell(Treg),and interleukin-17(IL-17) levels and FOXP3 mRNA expression showed no significant change on d2,and then markedly decreased on d7.Similarly,plasma IFN-concentration on d2 was much higher than that on d0,and then partly recovered on d7.As compared with the G group,in the G + E group,Th1 cell frequencies and the Th1/Th2 ratio were slightly higher on d2 and significantly higher on d7,while Th2,Th17,and Treg cell frequencies were slightly lower on d2,and significantly lower on d7.Consistently,on d7,IFN-mRNA and protein levels and the IFN-/IL-4 ratio in the G + E group were higher than those in the G group.In contrast,the IL-17 mRNA level,and IL-17 and transforming growth factor-1 concentrations in the G + E group were lower than those in the G group.CONCLUSION:G + E is superior to G in shifting the Th1/Th2 balance towards Th1,while decreasing Th17 and Treg,potentially benefiting HCC patients by promoting anti-tumor Th polarization.