麻醉技术在肺癌手术中的免疫调节作用:系统性审查和元分析
Georgios Konstantis1,2, Ilias Katsadouros1, Georgia Tsaousi3
1Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Medicina (Kaunas, Lithuania)
|July 30, 2025
概括
通用麻醉与外周麻醉相结合,对肺癌手术患者的关键免疫细胞计数产生积极影响. 这种组合可以改善细胞免疫力,可能会影响癌症预后和复发率.
科学领域:
- 免疫学 免疫学 免疫学
- 麻醉学 麻醉学
- 在瘤学瘤学.
背景情况:
- 肺癌是全球癌症死亡的主要原因之一.
- 手术切除是肺癌的主要治疗方法.
- 麻醉技术可以影响外科手术期间的免疫抑制,影响癌症的结果.
研究的目的:
- 系统地审查有关麻醉技术如何调节肺癌手术中的免疫反应的文献.
- 强调对细胞免疫的影响,包括特定的免疫细胞种群.
- 评估不同麻醉方法对免疫标记物的影响.
主要方法:
- 在PubMed,Scopus和Cochrane数据库的系统文献搜索 (2023年11月 - 2024年3月).
- 包括符合资格标准的随机对照试验 (RCT).
- 四个RCT的元分析比较单独的全身麻醉 (GA) 与外周麻醉 (EA) 的GA;三个RCT的定性和定量分析比较挥发性麻醉与全静脉麻醉 (TIVA).
主要成果:
- 结合GA和EA对各种术后时间点的CD3+细胞计数 (SMD-0.42至-0.86) 和CD4+细胞计数 (SMD-0.41至-0.56) 产生了积极影响.
- 手术后立即和术后72小时内,联合GA和EA (SMD -0.31至 -0.60) 对CD4+/CD8+比率产生了有利的影响.
- 对CD8+和NK细胞计数的聚合结果是不确定的;由于研究差异,基于挥发性与TIVA的分析是不确定的.
结论:
- 将全身麻醉与外周麻醉补充,证明对CD3+和CD4+细胞计数以及CD4+/CD8+比率产生有利影响.
- 这些发现表明,联合麻醉在肺癌手术期间保持细胞免疫力方面具有潜在的益处.
- 需要进一步进行高质量的研究来巩固这些结果,并探索对其他免疫细胞的影响.
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