The Effect Of Different Anesthetic Methods On Perioperative T-helper Polarization In Patients With Colorectal Cancer

Objective:To investigate the effect of different anesthetic methods on perioperative T-helper (Th) polarization in patients with colorectal cancer (CRC), and to explore the potential mechanism.Methods:40CRC patients, who were classified as ASA physical status I-II, underwent for elective colorectal surgery and were simultaneously randomized into two groups according to anesthetic methods (G group:general anesthesia, or E group: general anesthesia combining epidural anesthesia) with20cases in each arm. Venous blood samples were obtained before the induction of anesthesia (t0),1h after the start of surgery (t1),1h after the end of surgery (t2), and on the second (t3) and fifth (t4) day after the surgery. The dynamic changes of percentage of the subtypes of the T-helper (Thl, Th2, Thl7and Treg) were evaluated using flow cytometry, and the plasma IFN-y, IL-4, IL-10and TGF-β1were evaluated using enzyme-linked immunosorbent assay as well.Results:(1) There were no significant differences in age, gender, ASA physical status, Dukes stage, and anesthesia time between patients in G group and E group. All the tumors were confirmed to be gland carcinoma by postoperative pathology examination.(2) Compared with t0, the percentage of Thl in both groups at t3and t4increased significantly. The percentage of Treg in both groups at t2and t3decreased significantly. At t0, the percentage of Thl, Th2, Thl7and Treg had no significant difference between the two groups. Compared with G group, the percentage of Thl in E group was higher at time points t3and t4, and the percentage of Th2and Treg in E group were lower. The Thl/Th2ratio of E group was significant higher than that of G group from t2to t4.(3) The concentration of plasma IFN-y, IL-4, IL-10, and TGF-β1had no significant difference between the two groups. Compared with G group, the concentration of plasma IFN-γ and TGF-β1in E group increased after the surgery, however, the level of IL-4decreased.Conclusion:General anesthesia combined with epidural anesthesia might probably alleviate the suppression of anti-tumor immunity caused by surgical stress and anesthetics, therefore the colorectal cancer patients may benefit.