Effects of Remote Ischemic Preconditioning on Early Prognosis in Breast Cancer Patients undergoing Breast Cancer Surgery after Neoadjuvant Chemotherapy
Objective:To evaluate the effect of remote ischemic preconditioning(RIPC)on the early prognosis of breast cancer patients undergoing breast cancer surgery after neoadjuvant chemotherapy.Method:A total of 42 patients with breast cancer who planned to undergo surgery after neoadjuvant chemotherapy in Luoyang Central Hospital Affiliated to Zhengzhou University from June 2022 to July 2023 were selected as the study objects and randomly divided into control group and RIPC group,with 21 patients in each group.The two groups were treated with the same anesthesia method for breast cancer surgery.The RIPC group was treated with RIPC before surgery after anesthesia induction,while the control group was treated without RIPC.The operative indexes and postoperative recovery of the two groups were compared.The tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),interleukin-12(IL-12),8-isoprostaglandin F2α(8-iso-PGF2α)and regulatory T cells(Treg cells)before anesthesia(T1),at the beginning of surgery(T2),at the end of surgery(T3)and after surgery1 d(T4)between the two groups were compared.The mean arterial pressure(MAP),heart rate(HR),bifrequency index(BIS)at T1,T2 and T3 and the amount of vasoactive drugs between the two groups were compared.The quality of recovery-15 score(QOR-15)scores of the two groups at 1 d and 7 d after surgery were compared.Result:Postoperative exhaust time and getting out of bed time in RIPC group were earlier than those in control group,and patient satisfaction was higher than that in control group,the differences were statistically significant(P<0.05).There was no significant difference in the dosage of Norepinephrine between the two groups(P>0.05).At T2,T3 and T4,TNF-α,IL-10,IL-12,8-iso-PGF2α and peripheral blood Treg cells in both groups were higher than those at T1,and the differences were statistically significant(P<0.05).At T2,TNF-α,IL-12,8-iso-PGF2α and peripheral blood Treg cells in RIPC group were higher than those in control group,the differences were statistically significant(P<0.05).At T3 and T4,TNF-α,IL-12,8-iso-PGF2α and peripheral blood Treg cells in RIPC group were lower than those in control group,while IL-10 was higher than that in control group,the differences were statistically significant(P<0.05).The QOR-15 score of RIPC group were significantly higher than those of control group at 1 d and 7 d after surgery,the differences were statistically significant(P<0.05).Conclusion:RIPC can reduce the peroxidation stress reaction,inhibit inflammation and improve immune function in patients undergoing breast cancer surgery after neoadjuvant chemotherapy,which is conducive to early recovery of patients.
Remote ischemic preconditioningNeoadjuvant chemotherapyBreast cancer