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Effects of Anesthetic Methods on Hepatic Cancer Cell Function in Vitro

Not Applicable
Completed
Conditions
Hepatocellular Carcinoma
Interventions
Procedure: general anesthesia
Procedure: local anesthesia
Registration Number
NCT04510935
Lead Sponsor
RenJi Hospital
Brief Summary

Numerous studies find that anesthetic methods may influence the recurrence of tumor and the overall survival of patients after primary cancer surgery. Radiofrequency (RF) ablation is now widely used in the clinic for treatment of hepatocellular carcinoma (HCC). Currently, diverse anesthetic methods, including general anesthesia (GA), epidural anesthesia and local anesthesia (LA), are used for RF ablation surgery. Using serum from HCC surgery patients randomized to receive either GA or LA during surgery, we will investigate the effects of anesthetic methods on cellular invasion, migration and proliferation of HepG2 hepatic cancer cells in vitro. The expression levels of inflammatory cytokines in the serum from patients of both groups will also be analyzed.

Detailed Description

Patients diagnosed with hepatocellular carcinoma (HCC) undergoing elective radiofrequency (RF) ablation surgery will be randomly allocated to general anesthesia(GA) group or local anesthesia(LA) group.

Patients from GA group will receive anesthesia induced with 0.05-0.1mg/kg intravenous midazolam, 3-6ug/kg fentanyl, 1.0-2.5mg/kg propofol and 0.1-0.2mg/kg atracurium. Laryngeal mask will be used to maintain ventilation. Anesthesia will be maintained with 4-8mg/kg/h propofol and 0.1-0.3ug/kg/min remifentanil, and additional non-depolarizing muscle relaxant when necessary. In patients from LA group, analgesia will be provided by a subcutaneous injection of 2% lidocaine by the surgeons before insertion of the needles.

Serum will be collected from patients of both groups at before induction and 1h post-surgery. The HepG2 hepatic cancer cell line will be treated with patient serum from both groups. The effects of anesthetic methods on cellular invasion, migration, proliferation will be measured. The expression levels of inflammatory cytokines in the serum from patients of both groups will also be analyzed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
35
Inclusion Criteria
  • 18 to 65 years old
  • ASA grade I-III
  • Diagnosed with a single primary liver tumor of 3cm or smaller
  • Is scheduled for elective radiofrequency ablation surgery
  • With no macro-vascular invasion, no lymph node or extrahepatic metastases
  • Child-Pugh Class A or B
Exclusion Criteria
  • a history of liver surgery previously (including radiofrequency ablation)
  • severe systemic disease (heart, lung, kidney, or immune system)
  • INR>1.5 or platelet count <45,000 cells/mm3
  • a history of addiction to opioids;
  • Disagree to participate the trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
general anesthesiageneral anesthesiaPatients in this group will have RF ablation for treatment of HCC under general anesthesia.
local anesthesialocal anesthesiaIn this group, patients will receive radiofrequency ablation under local anesthesia.
Primary Outcome Measures
NameTimeMethod
mean percentage change from post- to pre-operative values of invasion of HepG2 cells cultured in patients' serumat 1 hour post-surgery

HepG2 cells will be cultured with serum from patients undergoing RF ablation under GA or LA for 24h. Cell invasion will be measured with Matrigel methods. Mean percentage change from post- to pre-operative values of invasion for each individual patient will be calculated and compared between the GA and LA groups.

Secondary Outcome Measures
NameTimeMethod
serum IL-1β levelat 1 hour post-surgery

an inflammatory mediator that reflects systemic inflammation

serum IL-6 levelat 1 hour post-surgery

an inflammatory mediator that reflects systemic inflammation

serum TNF-α levelat 1 hour post-surgery

an inflammatory mediator that reflects systemic inflammation

mean percentage change from post- to pre-operative values of migration of HepG2 cells cultured in patients' serumat 1 hour post-surgery

HepG2 cells will be cultured with serum from patients undergoing RF ablation under GA or LA for 24h. Cell migration will be measured with Transwell methods. Mean percentage change from post- to pre-operative values of migration for each individual patient will be calculated and compared between the GA and LA groups.

mean percentage change from post- to pre-operative values of proliferation of HepG2 cells cultured in patients' serumat 1 hour post-surgery

HepG2 cells will be cultured with serum from patients undergoing RF ablation under GA or LA for 24h. Cell proliferation will be measured with EdU methods. Mean percentage change from post- to pre-operative values of proliferation for each individual patient will be calculated and compared between the GA and LA groups.

serum IFN-gamma levelat 1 hour post-surgery

an inflammatory mediator that reflects systemic inflammation

serum IL-2 levelat 1 hour post-surgery

an inflammatory mediator that reflects systemic inflammation

Trial Locations

Locations (1)

Renji Hospital affliated to Shanghai Jiaotong University School of Medicine

🇨🇳

Shanghai, Shanghai, China

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