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Purpose: To investigate the effects of two types of anesthesia on postoperative recovery of patients with gastric cancer (GC), and to assess changes in the levels of their T lymphocyte subsets.
Methods: Patients with GC (200 cases) were randomly assigned to two groups of 100 patients each: general anesthesia (GA) group and GA + epidural anesthesia (GAEP) group. Fasting venous blood samples (2 mL) were collected from the patients before anesthesia, and at different time-points: zero time (T0), 1 h (T1), day 1 (T2), and day 3 (T3) after surgery. CD3+, CD4+, CD8+T, and regulatory T cells (Tregs) were determined using a flow cytometer.
Results: Percent CD3+, CD4+, CD8+T, and ratio of CD4+ to CD8+ in both groups at 1 h and day 1 after operation were significantly lower than their values before anesthesia (p < 0.05). There were significant differences in CD3+ and CD4+ levels between the two groups on day 3 (p < 0.05). Percent peripheral CD4+ CD25+T, and ratio of CD4+ CD25+ to CD4+ in both groups also significantly increased at 1 h and day 1 after operation, while percent peripheral CD4+, CD25+T and CD4+ CD25+ to CD4+ ratio in GAEP group on day 1 after operation were significantly lower than those of GA group (p < 0.05).
Conclusion: These results suggest that combination of general and epidural anesthesia partly controls the expressions of Tregs, thereby enhancing postoperative recovery of GC patients.
Keywords: Gastric cancer, T-lymphocyte subsets, Regulatory T-lymphocytes, Epidural, Anesthesia