CLINICAL RESEARCH
Propofol but not sevoflurane decreases circulating levels of sEGFR and sE-selectin after colorectal cancer surgery
1
2nd Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
2
Department of Laboratory Analysis, General Hospital “G. Gennimatas”, Athens, Greece
3
Department of Laboratory Analysis, Attikon University Hospital, Athens, Greece
4
Unit of Anaesthesia and Intensive Care Medicine, Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy
Submission date: 2019-04-06
Acceptance date: 2019-04-15
Publication date: 2019-07-18
Arch Med Sci Civil Dis 2019;4(1):41-50
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Surgery and anaesthesia may affect the outcomes of cancer. The aim of the study was to evaluate the effect of propofol or sevoflurane on cancer biomarkers such as interleukins, adhesion molecules, and EGFR.
Material and methods:
Eighty patients scheduled for colorectal cancer surgery were randomised to either propofol or sevoflurane anaesthesia. Blood samples for interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor (TNF-), interferon (IFN-), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), sE-selectin, and sEGFR measurements were obtained before induction of anaesthesia, at the end of surgery, and 72 h postoperatively.
Results:
Complete samples were obtained from 71 patients. Demographic data and anaesthesia/surgery-related data were similar between the two groups. There were significant differences produced by sevoflurane vs. propofol on the sE-selectin (median (IQR) 57.1 (59.2) vs. 42.7 (22.9) ng/ml, p = 0.011) and sEGFR (median (IQR) 49905.7 (22673.5) vs. 25.657.2 (13842.1) ng/ml, p < 0.001) concentrations postoperatively, while sEGFR plasma levels also showed a significant difference during surgery (median (IQR) 32964.5 (14402.5) vs. 25567.0 (13315.4) ng/ml, p = 0.04). IL-10 levels were significantly higher in the propofol group postoperatively (median (IQR) 13.7 (18.5) vs. 14.9 (66.6) pg/ml, p = 0.05).
Conclusions:
Given the role of EGFR and adhesion molecules on tumour progression and the generation of metastases, the inhibitory effect of propofol observed in this study might prove useful in the future. Further studies in larger populations investigating the effect of anaesthetic agents on these biomarkers are warranted.
Surgery and anaesthesia may affect the outcomes of cancer. The aim of the study was to evaluate the effect of propofol or sevoflurane on cancer biomarkers such as interleukins, adhesion molecules, and EGFR.
Material and methods:
Eighty patients scheduled for colorectal cancer surgery were randomised to either propofol or sevoflurane anaesthesia. Blood samples for interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor (TNF-), interferon (IFN-), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), sE-selectin, and sEGFR measurements were obtained before induction of anaesthesia, at the end of surgery, and 72 h postoperatively.
Results:
Complete samples were obtained from 71 patients. Demographic data and anaesthesia/surgery-related data were similar between the two groups. There were significant differences produced by sevoflurane vs. propofol on the sE-selectin (median (IQR) 57.1 (59.2) vs. 42.7 (22.9) ng/ml, p = 0.011) and sEGFR (median (IQR) 49905.7 (22673.5) vs. 25.657.2 (13842.1) ng/ml, p < 0.001) concentrations postoperatively, while sEGFR plasma levels also showed a significant difference during surgery (median (IQR) 32964.5 (14402.5) vs. 25567.0 (13315.4) ng/ml, p = 0.04). IL-10 levels were significantly higher in the propofol group postoperatively (median (IQR) 13.7 (18.5) vs. 14.9 (66.6) pg/ml, p = 0.05).
Conclusions:
Given the role of EGFR and adhesion molecules on tumour progression and the generation of metastases, the inhibitory effect of propofol observed in this study might prove useful in the future. Further studies in larger populations investigating the effect of anaesthetic agents on these biomarkers are warranted.
REFERENCES (40)
1.
Kim R. Effects of surgery and anesthetic choice on immunosuppression and cancer recurrence. J Transl Med 2018; 16: 8.
2.
Chen WK, Ren L, Wei Y, Zhu DX, Miao CH, Xu JM. General anesthesia combined with epidural anesthesia ameliorates the effect of fast-track surgery by mitigating immunosuppression and facilitating intestinal functional recovery in colon cancer patients. Int J Colorectal Dis 2015; 30: 475-81.
3.
Alsina E, Matute E, Ruiz-Huerta AD, Gilsanz F. The effects of sevoflurane or remifentanil on the stress response to surgical stimulus. Curr Pharm Design 2014; 20: 5449-68.
4.
Kennedy R, Celis E. Multiple roles for CD4+ T cells in anti-tumor immune responses. Immunol Rev 2008; 222: 129-44.
5.
Greenfeld K, Avraham R, Benish M, et al. Immune suppression while awaiting surgery and following it: dissociations between plasma cytokine levels, their induced production, and NK cell cytotoxicity. Brain Behav Immun 2007; 21: 503-13.
6.
Inada T, Yamanouchi Y, Jomura S, et al. Effect of propofol and isofurane anaesthesia on the immune response to surgery. Anaesthesia 2004; 59: 954-9.
7.
Melamed R, Bar-Yosef S, Shakhar G, Shakhar K, Ben-Eliyahu S. Suppression of natural killer cell activity and promotion of tumor metastasis by ketamine, thiopental, and halothane, but not by propofol: mediating mechanisms and prophylactic measures. Anesth Analg 2003; 97: 1331-9.
8.
Forget P, Collet V, Lavand’homme P, De Kock M. Does analgesia and condition infuence immunity after surgery? Effects of fentanyl, ketamine and clonidine on natural killer activity at different ages. Eur J Anaesthesiol 2010; 27: 233-40.
9.
Nishina K, Akamatsu H, Mikawa K, et al. The inhibitory effects of thiopental, midazolam, and ketamine on human neutrophil functions. Anesth Analg 1998; 86: 159-65.
10.
Benoliel AM, Pirro N, Marin V, Consentino B, Pierres A, Vitte J. Correlation between invasiveness of colorectal tumor cells and adhesive potential under flow. Anticancer Res 2003; 23: 4891-6.
11.
Alexiou D, Karayiannakis AJ, Syrigos KN, et al. Serum levels of E-selectin, ICAM-1 and VCAM-1 in colorectal cancer patients: correlations with clinicopathological features, patients’ survival and tumor surgery. Eur J Cancer 2001; 37: 2392-7.
12.
Etzioni A. Adhesion molecules: their role in health and disease. Pediatr Res 1996; 39: 191-8.
13.
Tremblay PL, Auger FA, Huot J. Regulation of transendothelial migration of colon cancer cells by E-selectin-mediated activation of p38 and ERK MAP kinases. Oncogene 2006; 25: 6563-73.
14.
McKay JA, Murray LJ, Curran S, et al. Evaluation of the epidermal growth factor receptor (EGFR) in colorectal tumours and lymph node metastases. Eur J Cancer 2002; 38: 2258-64.
15.
Goldstein NS, Armin MA. Epidermal growth factor receptor immunohistochemical reactivity in patients with American Joint Committee on Cancer Stage IV colon adenocarcinoma: implications for a standardized scoring system. Cancer 2001; 92: 1331-46.
16.
Resnick MB, Routhier J, Konkin T, Sabo E, Pricolo VE. Epidermal growth factor receptor, c-MET, beta-catenin, and p53 expression as prognostic indicators in stage II colon cancer: a tissue microarray study. Clin Cancer Res 2004; 10: 3069-75.
18.
Kurosawa S, Kato M. Anesthetics, immune cells, and immune responses. J Anesth 2008; 22: 263-77.
19.
Snyder GL, Greenberg S. Effect of anaesthetic technique and other perioperative factors on cancer recurrence. Br J Anaesth 2010; 105: 106-15.
20.
Santamaria LB, Schifilliti D, La Tore D, Fodale V. Drugs of anesthesia and cancer. Surg Oncol 2010; 19: 63-81.
21.
Kurosawa S. Anesthesia in patients with cancer disorders. Curr Opin Anaesthesiol 2012; 25: 376-84.
22.
Klampfer L. Cytokines, inflammation and colon cancer. Curr Cancer Drug Targets 2011; 11: 451-64.
23.
Zammaron BF, Chen WJ. Dual roles of immune cells and their factors in cancer development and progression. Int J Biol Sci 2011; 7: 651-8.
24.
Ullman TA, Itzkowitz SH. Intestinal inflammation and cancer. Gastroenterology 2011; 140: 1807-16.
25.
Deegan CA, Murray D, Doran P, Ecimovic P, Moriarty DC, Buggy DJ. Effect of anaesthetic technique on oestrogen receptor-negative breast cancer cell function in vitro. Br J Anaesth 2009; 103: 685-90.
26.
Kushida A, Inada T, Shingu K. Enhancement of antitumor immunity after propofol treatment in mice. Immunopharmacol Immunotoxicol 2007; 29: 477-86.
28.
Inada T, Kubo K, Shingu K. Possible link between cyclooxygenase-inhibiting and antitumor properties of propofol. J Anesth 2011; 25: 569-75.
29.
Lieuw-a-Fa M, Schalkwijk C, van Hinsbergh VWM. Distinct accumulation patterns of soluble forms of E-selectin, VCAM-1 and ICAM-1 upon infusion of TNFalpha in tumor patients. Thromb Haemost 2003; 89: 1052-7.
30.
Alexandrakis MG, Passam FH, Sfiridaki K, et al. Clinical significance of circulating endothelial adhesion molecules (sE-selectin and sICAM-1) in treated multiple myeloma patients. Clin Chem Acta 2004; 349: 39-43.
31.
De Cicco C, Ravasi L, Zorzino L, et al. Circulating levels of VCAM and MMP-2 may help identify patients with more aggressive pros- tate cancer. Curr Cancer Drug Targets 2008; 8: 199-206.
32.
Dymicka-Piekarska V, Kemona H. Does colorectal cancer clinical advancement affect adhesion molecules (sP-selectin, sE-selectin and sICAM-1) concentration? Thromb Res 2009; 124: 80-3.
33.
Korniluk A, Koper O, Kemona H, Dymicka-Piekarska V. From inflammation to cancer. Ir J Med Sci 2017; 186: 57-62.
34.
Köhler S, Richter U, Schumacher U. E-/P-selectins and colon carcinoma metastasis: first in vivo evidence for their crucial role in a clinically relevant model of spontaneous metastasis formation in the lung. Br J Cancer 2010; 102: 602-9.
35.
Ecimovic P, McHugh B, Murray D, Doran P, Buggy DJ. Effects of sevoflurane on breast cancer cell function in vitro. Anticancer Res 2013; 33: 4255-60.
36.
Huang H, Benzonana LL, Zhao H, et al. Prostate cancer cell malignancy via modulation of HIF-1 pathway with isoflurane and propofol alone and in combination. Br J Cancer 2014; 23: 1338-49.
37.
Chang SS, Califano J. Current status of biomarkers in head and neck cancer. J Surg Oncol 2008; 97: 640-3.
38.
Spano JP, Fagard R, Soria JC, Rixe O, Khayat D, Milano G. Epidermal growth factor receptor signaling in colorectal cancer: preclinical data and therapeutic perspectives. Ann Oncol 2005; 16: 189-94.
39.
Krasinskas AM. EGFR signaling in colorectal carcinoma. Patholog Res Int 2011; 2011: 932932.
40.
Miyamoto Y, Suyama K, Baba H. Recent advances in targeting the EGFR signaling pathway for the treatment of metastatic colorectal cancer. Int J Mol Sci 2017; 18: pii: E752.
Share
RELATED ARTICLE
| ISSN: | 2451-0637 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
