Effects of ketamine combined with lidocaine for preemptive analgesia on postoperative pain, inflammatory response and stress response in patients with cervical cancer

Objective:To investigate the effects of ketamine combined with lidocaine for preemptive analgesia on postoperative pain, inflammatory response and stress response in patients with cervical cancer.Methods: A total of 68 patients with cervical cancer who received radical operation in the hospital between July 2016 and May 2017 were divided into routine analgesia group (n=37) and ketamine group (n=31) according to the postoperative analgesic solution. Routine analgesia group received lidocaine for preemptive analgesia and ketamine group received ketamine combined with lidocaine for preemptive analgesia. The differences in serum levels of pain mediators, inflammatory factors and stress hormones were compared between the two groups before surgery (T0), immediately after postoperative recovery (T1) and 24h after surgery (T2).Results: At T0, there was no statistically significant difference in serum levels of pain mediators, inflammatory factors and stress hormones between the two groups. At T1 and T2, serum pain mediators SP and NPY levels of ketamine group were lower than those of routine analgesia group;inflammatory factors IL-1β, IL-6 and IL-8 levels were lower than those of routine analgesia group;stress hormones AngⅠ, AngⅡ and NE levels were lower than those of routine analgesia group.Conclusion: Ketamine combined with lidocaine for preemptive analgesia can effectively suppress the early postoperative pain mediator secretion and relieve the systemic inflammatory response and stress response in patients with cervical cancer.

The relationship of serum HE4, CP2 and HCgp-39 levels with tumor malignancy in patients with endometrial carcinoma

Objective:To study the relationship of serum human epididymis protein (HE4), cancer protein-2 (CP2) and human cartilage glycoprotein-39 (HCgp-39) levels with tumor malignancy in patients with endometrial carcinoma.Methods:A total of 90 patients with endometrial carcinoma treated in our hospital between May 2012 and August 2015 were collected and divided into early-to-mid (Ⅰ-Ⅲ stage) endometrial carcinoma group (n=59) and advanced (Ⅳ stage) endometrial carcinoma group (n=31) according to the pathological staging, and 34 patients with endometrial thickening who received uterine curettage in our hospital during the same period were selected as control group. The levels of HE4, CP2, HCgp-39 and tumor markers in serum as well as the mRNA expression of proliferation genes and invasion genes in tumor tissue were determined.Results:HE4, CP2, HCgp-39, CA125, CA19-9 and CEA levels in serum as well as Bcl2, Chk1, PIK1, HER2 and GDF-15 mRNA expression in tumor tissues of early-to-mid endometrial carcinoma group and advanced endometrial carcinoma group were significantly higher than those of control group while the miRNA-199a-3p, Bax, caspase3, BRCA1, Kiss-1 and KAI1 mRNA expression were lower than those of control group;HE4, CP2, HCgp-39, CA125, CA19-9 and CEA levels in serum as well as Bcl2, Chk1, PIK1, HER2 and GDF-15 mRNA expression in tumor tissues of advanced endometrial carcinoma group were significantly higher than those of early-to-mid endometrial carcinoma group while the miRNA-199a-3p, Bax, caspase3, BRCA1, Kiss-1 and KAI1 mRNA expression were lower than those of early-to-mid endometrial carcinoma group;serum HE4, CP2 and HCgp-39 levels were positively correlated with CA125, CA19-9, CEA, Bcl2, Chk1, PIK1, HER2 and GDF-15, and negatively correlated with miRNA-199a-3p, Bax, caspase3, BRCA1, Kiss-1 and KAI1. Conclusion:Serum HE4, CP2 and HCgp-39 levels can directly reflect the tumor malignancy in patients with endometrial carcinoma, and are expected to become the reliable means for tumor screening and treatment guidelines.