Regulation of the Inflammatory Profile of Blood Serum in Human Breast Cancer: Prominent Roles for TNF-alpha and RPR Pathways on Breast Surgery Inflammatory profile in human breast cancer

Ahmad Za'im Muhtar Mahfuddin (1), Yan Wisnu Prajoko (2), Mohamad Sofyan Harahap (3), Banundari Rachmawati (4), Widya Istanto Nurcahyo (5)
(1) Department of General Surgery, Dr. Kariadi Hospital-Diponegoro University, Semarang, Indonesia, Indonesia,
(2) Department of Oncology Surgery, Dr. Kariadi Hospital-Diponegoro University, Semarang, Indonesia, Indonesia,
(3) Department of Anesthesiology, Dr. Kariadi Hospital-Diponegoro University, Semarang, Indonesia, Indonesia,
(4) Department of Clinical Pathology, Dr. Kariadi Hospital-Diponegoro University, Semarang, Indonesia, Indonesia,
(5) Department of Anesthesiology, Dr. Kariadi Hospital-Diponegoro University, Semarang, Indonesia, Indonesia

Abstract

Background: The objective of this study is to compare the effects between the combination of PECS Block II with GA and GA alone on the inflammation levels in breast cancer, measure by Tumor Necrosis Factor-Alpha (TNF-α) and the red blood cell distribution width to platelet ratio (RPR).


Methods: Experimental analytical study with parallel randomized control trial was done in 48 breast cancer patients who underwent breast removal surgery at Dr. Kariadi Hospital between  August – October 2023. Patients were randomly allocated into 2 groups, control (GA only) and treatment (PECS Block II + GA). Demographic data were obtained preoperatively, blood samples were collected 24 hours before and after surgery. TNF-α levels were analyzed using enzyme-linked immunosorbant assay (ELISA), while RPR were obtained from complete blood count. Independent t and mann-whitney tests were used, with a p-value <0,05 was considered significant.


Results: Postoperative TNF-α levels were similar in both groups (8.15 ± 5.31 vs 6.21 ± 5.58; p=0,135), but the difference between TNF-α levels was significantly higher in treatment group (-5.08 ± 3.70; p = 0.001). Postoperative RPR levels were higher in control group than treatment group (0,64 ± 0,28 vs 0,50 ± 0,20; p=0,031), where the difference between RPR levels was higher in treatment group (-0,07 ± 0,19; p = 0,037).


Conclusion: Inflammatory biomarkers, in the form of TNF-α and RPR in breast cancer surgery were found to be lower with the usage of the combination of PECS Block II with general anesthesia than with general anesthesia only.

References

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Authors

Ahmad Za'im Muhtar Mahfuddin
openjanju@gmail.com (Primary Contact)
Yan Wisnu Prajoko
Mohamad Sofyan Harahap
Banundari Rachmawati
Widya Istanto Nurcahyo
1.
Mahfuddin AZM, Prajoko YW, Sofyan Harahap M, Rachmawati B, Istanto Nurcahyo W. Regulation of the Inflammatory Profile of Blood Serum in Human Breast Cancer: Prominent Roles for TNF-alpha and RPR Pathways on Breast Surgery: Inflammatory profile in human breast cancer. Arch Breast Cancer [Internet]. 2025 Jan. 31 [cited 2025 Apr. 23];12(1):47-54. Available from: https://archbreastcancer.com/index.php/abc/article/view/1012

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