The effect of propofol and sevoflurane on cancer cell, natural killer cell, and cytotoxic T lymphocyte function in patients undergoing breast cancer surgery: an in vitro analysis

Abstract

Background: To clarify the effect of anaesthetic agents on cancer immunity, we evaluated the effects of propofol and sevoflurane on natural killer (NK) cell, cytotoxic T lymphocyte (CTL) counts and apoptosis rate in breast cancer and immune cells co-cultures from patients who underwent breast cancer surgery.

Methods: Venous blood samples were collected after inducing anaesthesia and at 1 and 24 h postoperatively in patients who had undergone breast cancer surgery. The patients were allocated randomly to the propofol- or sevoflurane-based anaesthesia groups. We counted and detected apoptosis in cancer cell, NK cell and CTL of patients with breast cancer by co-culture with a breast cancer cell line in both groups. We also evaluated changes in the cytokines tumour necrosis factor-alpha, interleukin (IL)-6 and IL-10 during the perioperative period.

Results: Forty-four patients were included in the final analysis. No difference in NK cell count, CTL count or apoptosis rate was detected between the groups. Furthermore, the number of breast cancer cells undergoing apoptosis in the breast cancer cell co-cultures was not different between the groups. No changes in cytokines were detected between the groups.

Conclusion: Although basic science studies have suggested the potential benefits of propofol over a volatile agent during cancer surgery, propofol was not superior to sevoflurane, on the aspects of NK and CTL cells counts with apoptosis rate including breast cancer cell, during anaesthesia for breast cancer surgery in a clinical environment.

Trial registration: NCT02758249 on February 26, 2016.

Keywords: Breast cancer; Cytotoxic T lymphocyte; Natural killer cell; Propofol; Sevoflurane.

Fig. 1

CONSORT flow diagram

Fig. 2

Changes in natural killer (NK) cell count, apoptosis and cytotoxicity. a. Changes in NK cell count, b. Changes in NK cell apoptosis, c. Changes in NK cell cytotoxicity. Abbreviations: Preop, immediate before anaesthesia induction; Post 1h, at postoperative 1 h; Post 24h, at postoperative 24 h

Fig. 3

Changes in cytotoxic T cell count and apoptosis. a. Changes in cytotoxic T cell count, b. Changes in cytotoxic T cell apoptosis. Abbreviations: Preop, immediate before anaesthesia induction; Post 1h, at postoperative 1 h; Post 24h, at postoperative 24 h

Fig. 4

Changes in breast cancer cell number and apoptosis rate in co-culture with NK and cytotoxic T cells. a. Changes in cancer cell number with NK cell, b. Changes in cancer cell apoptosis with NK cell, c. Changes in cancer cell number with cytotoxic T cell, d. Changes in cancer cell apoptosis with cytotoxic T cell. Abbreviations: Preop, immediate before anaesthesia induction; Post 1h, at postoperative 1 h; Post 24h, at postoperative 24 h