The Effects Of Sevoflurane Inhalation Anesthesia And Radical Mastectomy On Perioperative Cellular Immunologic Function For Patients With Or Without Preoperative Chemotherapy

Object: To evaluate the effects of sevoflurane inhalation anesthesia on T lymphocytesubsets and NK cells in breast cancer patients undergoing radical mammotomy whowas used chemicaltherapy or not used chemicaltherapy preoperation, and to detectthe micrometastases status in peripheral blood of those patients by reversetranscripition-polymerise chain reaction(RT-PCR).Methods: Twenty brest cancer patients who was used chemicaltherapy and twentybrest cancer patients who was not used chemicaltherapy were randomly chosen, andthey were divided into two group. Groupâ… not use chemicaltherapy and groupâ…¡usechemicaltherapy. 4ml peripheral venous blood samples were taken before anesthesia,after operation and 72 hours postoperation, 1ml was for determining T-lymphocyteCD3~+, CD4~+, CD8~+, CD4~+/CD8~+ and NK cells by flowcytomete and 3ml was fordetecting the CK19mRNA using RT-PCR.Results: In both groups, the CD3~+, CD4~+, CD8~+ and CD4~+/CD8~+ were all decreasedafter operation. Moreover, compared with before anesthesia significant differenceswere found in groupâ… 's CD3~+,CD4~+ and groupâ…¡'s CD4~+. However, 72 hourspostoperation, the CD3~+,CD4~+,CD8~+ and CD4~+/CD8~+ were nomall. NK cellsdecreased gradually both after operation and 72 hours postoperation. Meanwhile,there was no significant difference between these two groups. Finally, there wereeach two cases detected that CK19mRNA was expressed in the peripheral venousblood, so 10% was positive, andâ…¡stage is much higher thanâ… stage patientsobviously.Conclusion: After using sevoflurane inhalation anesthesia to breast cancer patientsundergoing radical mammotomy who was used chemicaltherapy or not usedchemicaltherapy preoperation, there were depressant effect to the patient's immunosystem, especially for NK cells. Other whiles, there is no relation with thepatients whether received chemotherapy. In the patient's vessel blood there aremicrometastases existed, but whether the depressant effect leads to the tumor cellsmicrometastases, it should be further study.