Abstract: Objective To evaluate the effect of full intravenous anesthesia and full inhalation anesthesia on peripheral blood helper T cell subtypes and their related cytokines [interleukin (IL)‑17A, interferon‑γ (IFN‑γ), IL‑6 and IL‑10] in patients with invasive breast cancer during perioperative period and the perioperative outcome. Methods According to the random number table method, sixty patients with invasive breast cancer, American Society of Anesthesiologists (ASA) Ⅰ‒Ⅱ, aged 35‒75, TNM stage Ⅰ‒Ⅱ, body mass index (BMI) 18.5‒28.0 kg/m2, were randomly divided into propofol full intravenous anesthesia group (intravenous group) and full sevoflurane inhalation anesthesia group (inhalation group) (n=30). Anesthesia induction: midazolam 0.04 mg/kg, fentanyl 6 μg/kg, propofol 1.5‒2.0 mg/kg, cisatracurium benzene sulfonate 0.3 mg/kg were used in the intravenous group; etomidate 0.2 mg/kg was used in the inhalation group instead of propofol, and the other induction drugs were the same as the intravenous group. In the intravenous group, propofol was infused continuously in target‑controlled infusion (TCI) mode to maintain anesthesia, and the target concentration was 3‒4 mg/L; in the inhalation group, sevoflurane was inhaled continuously in 1.5%‒2.0% concentration, and bispectral index (BIS) index was maintained in 40‒60. On the day of operation (D0), the first day after operation (D1), and the third day after operation (D3), 3 ml of peripheral venous blood was collected from the two groups. The absolute and relative counts of CD4+CD25+Foxp3+ regulatory T lymphocytes in peripheral blood were measured by flow cytometry. The cytokines IL‑17A, IFN‑γ, IL‑6 and IL‑10 concentration were measured by flow cytometry. Results Compared with the level of D0, the absolute and relative counts of CD4+CD25+Foxp3+regulatory T lymphocytes in the peripheral blood of the two groups were decreased at D1, whereas the concentrations of IL‑17A and IL‑6 were increased (P<0.05), compared with D3, the level in the two groups almost basically recovered to D0. The concentration of IL‑17A and IL‑6 in the intravenous group was lower at D1 than that in the inhalation group (P<0.05) while there was no significant difference among the other indexes at the same time point. Conclusions Full propofol intravenous anesthesia and full sevoflurane inhalation anesthesia have no significant effect on the content of CD4+CD25+Foxp3+ regulatory T cells in the peripheral blood of patients with modified radical mastectomy. Compared with full inhalation anesthesia, full intravenous anesthesia can inhibit the overexpression of IL‑17A and IL‑6, which may be beneficial to preventing perioperative inflammation and immune protection of patients with breast cancer.
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