| Object: Multiple aspects such as surgery and anesthesia during perioperational period of malignant tumor could induce entrance of tumor cells into blood circulation and lymphokinesis and bone marrow even metastasis.Meanwhile,stress reaction of surgery also leads to neuroendocrine,metabolic and inflammation reactions which inhibit cell immune and raise the risk of tumor recurrence and metastasis,eventually impacts survival of malignance patients.Anesthesia techniques and drugs act with immune cells and hypothalamus-pituitary-adrenal axis to regulate the function of immune system,then impact recurrence and metastasis of tumor.Lidocaine is the only vein injectable local anesthetics during perioperational period which could not only pain-easing,antihyperpathia and anti-arrhythmia,but also impact the prognosis of tumor patients.On the other hand,lidocaine regulates tumor cell behaviors directly and indirectly,also alleviates immune inhibition by surgery and reduces require of opiates,protects immune cells functions,and eventually,impact the prognosis of tumor patients.This research is aim to reveal the effect of lidocaine vein-injection during perioperation period to lymph cells,NK cells,Treg cells and so on,and discover the evidence of application of lidocaine in clinical tumor therapy.Methods: Forty colorectal cancer patients which were going to undergo laparoscopic assisted radical resection for colorectal cancer from April to September 2016 in the Second Hospital of Chongqing Medical University were chosen for our research.All patients with informed consent were divided into control group and lidocaine group with a random number table,20 patients per group.Meanwhile,there was no statistical significance in comparison of clinical basic data between these two groups.Lidocaine was vein-injected with special venous channel for 15 min before anesthesia induction.During general intravenous anesthesia,lidocaine was continuously-pumped until surgery ended.In control group,isovolumetric normal saline was injected instead.Ten ml venous blood was drew at 24 h before lidocaine injection,0h after surgery and 24 h after surgery.All samples were anticoagulated with EDTA and sent to FCM for analysis within 24 h.Results:1.Comparisons of general data such as age,BMI of two groups did not reach statistical significance(p>0.05).2.Compared with 24 h before surgery(T0),reduction of white cells in T1(0h after surgery)and T2(24h after surgery)were found,and these reductions were all reached statistical significances.However,compared with control group,less reduction was found in lidocaine group,and when it was in T2,a statistical significance was also observed.3.Compared with T0,percentages of T lymphocytes in all lymphocytes in T1 and T2 in both groups increased at first and then decreased.Compared with control group,a faster rise of percentages of T lymphocytes in T1 and a slower decrease in T2 were observed in lidocaine group.Difference of percentages of T lymphocytes reached statistical significance in T2.4.Compared with T0,the percentage of Th cells in T cells and ratio of CD4+/CD8+ were increased at first and then decreased;percentage of CTL was decreased at first and then increased;and in lidocaine group,these changes reached statistical significance.Compared with control group,the percentage of Th cells in T cells and ratio of CD4+/CD8+ were increased faster in lidocaine group in T1,and decreased slower in T2 and reached statistical significance.5.Compared with T0,the percentage of Treg cells in T cells was decreased in T1 and T2 in lidocaine group,and the decrease in T2 reached statistical differences.But no statistical difference was found in control group.Compared with control group,this change in T1 reached statistical significance.6.Compared with T0,NK cells in T1 and T2 in both groups were decreased at first then increased,but no statistical difference was found.Conclusion:1.Surgery stress could inhibit proliferation of lymphocytes,but lidocaine vein-injection in perioperation period alleviated this effect.2.An alleviation of surgery inhibiting immunoreaction induced by T lymphocytes when lidocaine was vein-injected in perioperation period.3.An inhibition of CD127-Treg cell proliferation was found when lidocaine was vein-injected in perioperation period.4.No obvious impact to NK cells was found when lidocaine was vein-injected in perioperation period. |
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