围麻醉期影响肿瘤转移和复发的研究进展

Research advances of perianesthesia on tumor metastasis and recurrence

背景 肿瘤的高发病率和高病死率给医学带来了巨大的挑战，肿瘤切除术是肿瘤治疗的主要手段之一，但研究表明麻醉药物和技术可影响肿瘤术后复发与转移。 目的 阐述麻醉药物、技术对术后肿瘤转移及复发的影响，为临床麻醉策略提供参考。 内容 肿瘤的发生发展与免疫系统监控有着密切联系，重点讨论麻醉药物以及技术通过促进或抑制免疫系统以及介导信号转导通路参与炎症、肿瘤转移复发等病理过程。 趋向 大样本多中心随机对照试验为阐明麻醉与肿瘤术后转移及复发的关系提供更多的证据，这些证据是提高肿瘤患者生存率的关键。

Background Excision surgery provides a chance of cure for patients with cancer, but most cancer-related deaths in patients who have received previous surgical treatment are caused by metastatic diseases. Recent research suggests that a few anesthetic agents or procedures can influence pathophysiology of metastasis in the postoperative period. Objective This review summarizes the evidence for an impact of anesthesia agents on patient outcome after cancer surgery, which provides effective anesthesia strategy. Content The development of tumor is closely related to the immune system monitoring. This review describes tumor immunity and the effects of various anesthetic agents and anesthesia techniques on tumor recurrence after surgery. Trend Only randomized, clinical trials can provide us with conclusive reports about the link between anesthesia and tumor recurrence, which is the key in improving surviving rate of cancer patients.