摘要
目的探讨全身麻醉中应用右美托咪定的患者血清对乳腺癌细胞MCF-7增殖能力的影响。方法选取2017年4—7月间在上海交通大学医学院附属仁济医院择期行手术治疗的原发性乳腺癌(T_(2～4)N_(0～2)M_0)患者20例,按照数字表将患者随机分入右美托咪定组和对照组,每组10例。右美托咪定组于麻醉诱导前经静脉输液泵持续注射负荷剂量(1μg/kg)右美托咪定15min,至麻醉诱导时改为0.5μg/(kg·h)经静脉输液泵持续注射2h;对照组给予相同剂量的0.9%氯化钠溶液。分别于麻醉前和手术结束后24h抽取患者外周静脉血10mL,离心后取血清,以5%终浓度培养人乳腺癌细胞MCF-7 48h。采用细胞计数试剂盒-8(CCK-8)试验和5-乙炔基-2’-脱氧尿苷(EdU)阳性标记率法检测两组患者麻醉前和手术后血清培养的乳腺癌细胞MCF-7增殖的情况。比较两组手术后与麻醉前CCK-8在波长450nm处的吸光度值(A_(450)值)、EdU阳性标记率,以及手术后较麻醉前CCK-8 A_(450)值和EdU阳性标记率增加的幅度。结果两组患者间手术时间、术中麻黄素用量、手术方式、肿瘤最大径,以及肿瘤雌激素受体阳性、肿瘤孕激素受体阳性、肿瘤人表皮生长因子受体2阳性患者构成的差异均无统计学意义(P值均>0.05)。右美托咪定组手术后CCK-8 A_(450)值和EdU阳性标记率均显著高于同组麻醉前(P值均<0.01),对照组麻醉前与手术后CCK-8 A_(450)值和EdU阳性标记率的差异均无统计学意义(P值均>0.05)。右美托咪定组CCK-8 A_(450)值和EdU阳性标记率的增加幅度分别为0.35±0.10和0.40±0.11,均显著高于对照组的0.16±0.08和0.10±0.15(P值分别<0.01、0.05)。结论全身麻醉时使用右美托咪定有可能通过改变机体血液内环境促进乳腺癌细胞增殖,从而影响乳腺癌患者手术后的转归。
Objective To investigate the effect of serum of patients receiving dexmedetomidine during general anesthesia on the proliferation of Michigan cancer foundation-7 （MCF-7） cells, Methods Twenty women who suffered from primary breast cancer （T2-4 N0-2 M0 ） and underwent elective surgery under general anesthesia between April 2017 to July 2017 were randomly allocated to dexmedetomidine group or control group （n = 10）. Patients in the dexmedetomidine group received a loading dose of 1 μg/kg dexmedetomidine since 15 rain before induction and another 1 μg/kg dexmedetomidine at a rate of 0.5 μg/（kg ·h） for 2 continuous hours during surgery. Patients in the control group received the same amount of normal saline. Serum from peripheral venous blood （10 mL） was collected from all patients immediately before anesthesia induction and at 24 h after operation and then were used to treat MCF-7 cells. Proliferation of MCF-7 cells was measured using cell counting kit-8 （CCK-8） and 5-ethynyl-2‘-deoxyuridine （EdU） labelling methods. Absorbance value in the 450 nm wave length （A450）, EdU positive labelling rate and the growth of A4s0 and EdU positive labelling rate were compared between two groups.Results No significant difference was found in the operation time, ephedrine consumption, operation methods, maximum diameter of the tumor, constituent ratio patients with positive estrogen receptor of tumor, positive progesterone receptor of tumor or positive epidermal growth factor receptor 2 of tumor between two groups （all P〈0.05）. Postoperative A450 and EdU positive labelling rate were significantly higher than preoperative ones in the dexmedetomidine group （both P〈0.01）, while postoperative A450 and EdU positive labelling rate were not obviously increased in the control group （both P〈0.05）. The increase of A4s0 and EdU positive labelling rate were 0.35±0.10 and 0.40±0. 11, respectively, in the dexmedetomidine group, which were significantly higher than those in the control grou
作者
陆晓英
刘艳
孙佳昕
苏殿三
段宏伟
俞卫锋
陆劲松
田婕
LU Xiaoying;LIU Yan;SUN Jiaxin;SU Diansan;DUAN Hongwei;YU Weifeng;LU Jinsong;TIAN Jie(Deportment of Anesthesiology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)
出处
《上海医学》
CAS
北大核心
2018年第5期275-279,共5页
Shanghai Medical Journal
基金
浦东新区卫生和计划生育委员会重点专科建设项目(PWZzk2017-06)
关键词
乳腺肿瘤
右美托咪定
细胞增殖
Breast neoplasms
Dexmedetomidine
Cell proliferation
