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
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.
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References
Manuaba TW. 2010. Panduan Penatalaksanaan Kanker Solid PERABOI. Jakarta, Sagung Seto.
Alkabban FM, Ferguson T. Breast Cancer. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482286/. PMID: 29493913
Desborough JP: The stress response to trauma and surgery. Br J Anaesth. 2000;85(1):109–17 10.1093/bja/85.1.109. DOI: 10.1093/bja/85.1.109
Allen MD, Jones LJ. The role of inflammation in progression of breast cancer: friend or foe?(Review). Int J Oncol. 2015;47(3):797-805. DOI: 10.3892/ijo.2015.3075
Warwick R, Mediratta N, Shackcloth M, Shaw M, McShane J, Poullis M. Preoperative red cell distribution width in patients undergoing pulmonary resections for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;45(1): 108-13. DOI: 10.1093/ejcts/ezt275
Bozkurt G, Korkut AY, Soytaş P, Dizdar SK, Erol ZN. The role of red cell distribution width in the locoregional recurrence of laryngeal cancer. Braz J Otorhinolaryngol. 2019;85(3):357–64. DOI: 10.1016/j.bjorl.2018.03.004
Hsing CH, Wang JJ. Clinical implication of perioperative inflammatory cytokine alteration. Acta Anaesthesiol Taiwanica. 2015;53(1):23–8. DOI: 10.1016/j.aat.2015.03.002
Wall T, Sherwin A, Ma D, Buggy DJ. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: a narrative review. Br J Anaesth. 2019;123(2):135–50. DOI: 10.1016/j.bja.2019.04.062
Bashandy GMN, Abbas DN. Pectoral nerves I and II blocks in multimodal analgesia for breast cancer surgery: a randomized clinical trial. Reg Anesth Pain Med. 2015;40(1):68–74.
Cui X, Zhu C, Chen P, Qu M, Zhang B, Li H. Effect of pectoral nerve block type II under general anesthesia on the immune function of patients with breast cancer. Am J Surg [Internet]. 2020;220(4):938–44. Available from: https://doi.org/10.1016/j.amjsurg.2020.03.008. DOI: 10.1097/AAP.0000000000000163
Yoon, J. Y., Kwak, M. S., Kim, H. I., & Cha, J. M. (2021). Seasonal variations in the diagnosis of the top 10 cancers in Korea: A nationwide population-based study using a common data model. Journal of gastroenterology and hepatology, 36(12), 3371–3380. h. DOI: 10.1111/jgh.15634
Holmberg, L., Adolfsson, J., Mucci, L., Garmo, H., Adami, H. O., Möller, H., Johansson, J. E., & Stampfer, M. (2009). Season of diagnosis and prognosis in breast and prostate cancer. Cancer causes & control : CCC, 20(5), 663–670. https://doi.org/10.1007/s.
Doyle DJ, Hendrix JM, Garmon EH. American Society of Anesthesiologists Classification. [Updated 2022 Dec 4]. In: StatPearls Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441940/. DOI: 10.1007/s10552-008-9279-6
Parameswaran N, Patial S. Tumor Necrosis Factor-α Signaling in Macrophages. Crit Rev Eukaryot Gene Expr. 2010;20(2):87. DOI: 10.1615/critreveukargeneexpr.v20.i2.10
An L, Dou X, Wang M, Luo W, Ma Q, Liu X. Involvement of TNF-alpha and IL-10 in breast cancer and patient survival. Trop J Pharm Res. 2020;19(10):2033–9. DOI: 10.4314/tjpr.v19i10.2
Liu W, Lu X, Shi P, Yang G, Zhou Z, Li W, et al. TNF-α increases breast cancer stem-like cells through up-regulating TAZ expression via the non-canonical NF-κB pathway. Sci Reports 2020 101. 2020 Feb;10(1):1–11. DOI: 10.1038/s41598-020-58642-y
Vosoughian M, Dahi M, Dabir S, Moshari M, Tabashi S, Mosavi Z. Effects of General Anesthesia Versus Spinal Anesthesia on Serum Cytokine Release After Cesarean Section: A Randomized Clinical Trial. Anesthesiol Pain Med 2021 112. 2021 Apr;11(2):111272. DOI: 10.5812/aapm.111272
Tseng WC, Lai HC, Huang YH, Chan SM, Wu ZF. Tumor Necrosis Factor Alpha: Implications of Anesthesia on Cancers. Cancers (Basel). 2023 Feb;15(3). DOI: 10.3390/cancers15030739
Takeuchi, H., Abe, M., Takumi, Y., Hashimoto, T., Miyawaki, M., Okamoto, T., & Sugio, K. (2019). Elevated red cell distribution width to platelet count ratio predicts poor prognosis in patients with breast cancer. Scientific reports, 9(1), 3033. DOI: 10.1038/s41598-019-40024-8
Wang PF, Song SY, Guo H, Wang TJ, Liu N, Yan CX. Prognostic role of pretreatment red blood cell distribution width in patients with cancer: A meta-analysis of 49 studies. J Cancer. 2019;10(18):4305–17. DOI: 10.7150/jca.31598
Takeuchi H, Abe M, Takumi Y, Hashimoto T, Miyawaki M, Okamoto T, et al. Elevated red cell distribution width to platelet count ratio predicts poor prognosis in patients with breast cancer. Sci Rep. 2019;9(1):1–7. DOI: 10.1038/s41598-019-40024-8
Lee HS, Jung EJ, Kim JM, Kim JY, Kim JR, Kim TH, et al. The usefulness of red blood cell distribution width and its ratio with platelet count in breast cancer after surgery and adjuvant treatment: a retrospective study. Gland Surg. 2022;11(12):1864–73. DOI: 10.21037/gs-22-410
Goyal, H., Gupta, S., & Singla, U. (2016). Level of red cell distribution width is affected by various factors. Clinical chemistry and laboratory medicine, 54(12), e387. https://doi.org/10.1515/cclm-2016-0195.
Karachaliou, N., Pilotto, S., Bria, E., & Rosell, R. (2015). Platelets and their role in cancer evolution and immune system. Translational lung cancer research, 4(6), 713–720. https://doi.org/10.3978/j.issn.2218-6751.2015.10.09 (Retraction published Trans.
Høgevold, H. E., Lyberg, T., Kähler, H., Haug, E., & Reikerås, O. (2000). Changes in plasma IL-1beta, TNF-alpha and IL-6 after total hip replacement surgery in general or regional anaesthesia. Cytokine, 12(7), 1156–1159. https://doi.org/10.1006/cyto.2000.
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