The Effect Of Total Intravenous Anesthesia Underwent Neoadjuvant Chemotherapy On Breast Cancer Patients With Modified Radical Mastectomy Treg Cells

Objective To investigate the effects of total intravenous anesthesia to T lymphocyte subsets, Treg cells, three lines of blood cells,liver and kidney function between preoperative chemotherapy and nonchemotherapy of modified radical mastectomy patients. Method Part I: 1076 cases inpatient who proceeding breast cancer surgery at the General Hospital of Ningxia Medical Surgical Oncology from January in 2010 to December in 2012 were collected, 307 cases fully met the inclusion and exclusion criteria, patients were divided into two groups according to whether they accepted preoperative neoadjuvant chemotherapy, 143 cases were chemotherapy and 164 cases were non- chemotherapy. To analyze the white blood cell counts, red blood cell counts, platelet counts, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and serum creatinine values between the two groups preoperation and postoperation. Part II: 58 cases of female patients who hospitalized in surgical oncology and were confirmed with breast cancer by pathology were chosen from March 2013 to December 2013 at the General Hospital of Ningxia Medical University Oncology Hospital, patients were divided into two groups according to whether they accepted preoperative chemotherapy: 27 cases were non- chemotherapy group(Group C), 31 cases were chemotherapy group( N Group). T cell subsets and the number of Treg cells were tested before induction of anesthesia, after the end of surgery, postoperative 24 hours respectively. Results: CD3+, CD4+, CD8+of peripheral blood in the two groups of patients were decreased after procedure compared with the pre-induction, postoperative and postoperative 24 h decreased significantly(P<0.05); there were no significant differences between the two group in different time point(P>0.05); Proportion of Treg cells in peripheral blood of postoperative patients were was significantly increased compared to pre-induction,(P<0.05); There were significant differences between the two groups of Treg cells preoperative and postoperative,(P <0.05). Conclusion Part I: 1) White blood cell counts, red blood cell counts and platelet counts were suppressed in chemotherapy compared to non- chemotherapy group before surgery. 2) White blood cell count, red blood cell counts and platelet counts were inhibited by total intravenous anesthesia on patients with neoadjuvant chemotherapy, especially to platelet counts. 3) liver and kidney function were also effected by total intravenous anesthesia in patients but still in normal range. Part II: 1) T lymphocyte subsets were affected by the application of total intravenous anesthesia to preoperative chemotherapy and non- chemotherapy patients with radical mastectomy, this kind of inhibition had nothing to do with the patients whether they had adjuvant chemotherapy or not before surgery. 2) chemotherapy can reduce the proportion of Treg cells in peripheral blood of breast cancer patients, thereby reducing immunosuppressive Treg cell function, proportion of Treg cells in peripheral blood of patients can be increased by total intravenous anesthesia which can reverse the descending of Treg cells in peripheral blood of the patient with chemotherapy.