Effect of anesthetic technique on serum vascular endothelial growth factor C and prostaglandin E2 levels in women undergoing surgery for uterine leiomyomas

Yonghai Zhang, Jingfang Yu, Fan Yang, Liyan Zhao, Ling Ma, Huiwen Zhang, Xuexin Chen, Hanxiang Ma, Yonghai Zhang, Jingfang Yu, Fan Yang, Liyan Zhao, Ling Ma, Huiwen Zhang, Xuexin Chen, Hanxiang Ma

Abstract

Objective: Angiogenesis is essential for growth and recurrence of uterine leiomyomas, and angiogenesis is mediated by vascular endothelial growth factor C (VEGF-C) and prostaglandin E2 (PGE2). This study investigated whether spinal anesthesia (SA) with continuous postoperative epidural analgesia attenuates postoperative changes in these angiogenic factors compared with general anesthesia (GA) with patient-controlled intravenous analgesia.

Methods: Forty-four women with uterine leiomyomas undergoing abdominal myomectomy were randomized to receive either standard SA or GA. Blood samples were taken before anesthesia and at 48 hours after surgery for measuring serum VEGF-C and PGE2 levels, which were analyzed by using enzyme-linked immunosorbent assays. Visual analog scale pain scores were used to evaluate postoperative pain.

Results: Serum VEGF-C and PGE2 levels were not significantly different preoperatively between the SA and GA groups, but they were decreased in each group at 48 hours after surgery compared with preoperatively. The change in pre- and postoperative VEGF-C levels was smaller in the GA group than in the SA group.

Conclusions: Removal of uterine leiomyomas by surgery can reduce serum VEGF-C and PGE2 levels. The anesthetic technique affects serum VEGF-C levels, which are associated with angiogenesis in surgery for leiomyomas.

Keywords: Analgesia; anesthesia; leiomyoma; prostaglandin; tumor; vascular endothelial growth factor.

References

    1. Mohamed S, Ayman AH. Medical treatment of uterine leiomyoma. Reprod Sci 2012; 19: 339–353.
    1. Lee M, Cheon K, Chae B, et al. Analysis of MED12 mutation in multiple uterine leiomyomas in South Korean patients. Int J Med Sci 2018; 15: 124–128.
    1. Hague S, Zhang L, Oehler MK, et al. Expression of the hypoxically regulated angiogenic factor adrenomedullin correlates with uterine leiomyoma vascular density. Clin Cancer Res 2000; 6: 2808–2814.
    1. Gentry CC, Okolo SO, Fong LF, et al. Quantification of vascular endothelial growth factor-A in leiomyomas and adjacent myometrium. Clin Sci (Lond) 2001; 101: 691–695.
    1. Flake GP, Janet A, Darlene D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect 2003; 111: 1037–1054.
    1. Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril 2007; 87: 725–736.
    1. Forget P, Vandenhende J, Berliere M, et al. Do intraoperative analgesics influence breast cancer recurrence after mastectomy? A retrospective analysis. Anesth Analg 2010; 110: 1630–1635.
    1. Davies G, Martin LA, Sacks N, et al. Cyclooxygenase-2 (COX-2), aromatase andbreast cancer: a possible role for COX-2inhibitors in breast cancer chemoprevention. Ann Oncol 2002; 13: 669–678.
    1. Huskisson EC. Measurement of pain. Lancet 1974; 2: 1127–1131.
    1. Chen DC, Liu JY, Wu GJ, et al. Serum vascular endothelial growth factor165 levels and uterine fibroid volume. Acta Obstet Gynecol Scand 2005; 84: 317–321.
    1. Ciarmela P, Islam MS, Reis FM, et al. Growth factors and myometrium: biological effects in uterine fibroid and possible clinical implications. Hum Reprod Update 2011; 17: 772–790.
    1. Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases. Nature 2000; 407: 249–257.
    1. Yancopoulos GD, Davis S, Gale NW, et al. Vascular-specific growth factors and blood vessel formation. Nature 2000; 407: 242–248.
    1. Inoue M, Itoh H, Ueda M, et al. Vascular endothelial growth factor (VEGF) expression in human coronary atherosclerotic lesions: possible pathophysiological significance of VEGF in progression of atherosclerosis. Circulation 1998; 98: 2108–2116.
    1. Looney M, Doran P, Buggy DJ. Effect of anesthetic technique on serum vascular endothelial growth factor C and transforming growth factor β in women undergoing anesthesia and surgery for breast cancer. Anesthesiology 2010; 113: 1118–1125.
    1. O’Riain SC, Buggy DJ, Kerin MJ, et al. Inhibition of the stress response to breast cancer surgery by regional anesthesia and analgesia does not affect vascular endothelial growth factor and prostaglandin E2. Anesth Analg 2005; 100: 244–249.
    1. Sheng H, Shao J, Washington MK, et al. Prostaglandin E2 increases growth and motility of colorectal carcinoma cells. J Biol Chem 2001; 276: 18075–18081.
    1. Ke X, Dou F, Cheng Z, et al. High expression of cyclooxygenase-2 in uterine fibroids and its correlation with cell proliferation. Eur J Obstet Gynecol Reprod Biol 2013; 168: 199–203.
    1. Leahy KM, Ornberg RL, Wang Y, et al. Cyclooxygenase-2 inhibition by celecoxib reduces proliferation and induces apoptosis in angiogenic endothelial cells in vivo. Cancer Res 2002; 62: 625–631.

Source: PubMed

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