The influence of surgery and anesthesia on lymphocyte functions in breast cancer patients: in vitro effects of indomethacin

Surgical trauma and anesthesia may lead to the postoperative immunosuppress ion, the exact mechanism of which is still unresolved. Among various factor s, the role of prostaglandine PGE(2)-mediated suppression was also proposed . We investigated the influence of surgery and two anesthetic regimes on ly mphoproliferative response (LPR) to PHA and on NK cell activity (MTT) in br east cancer patients, as well as the effect of indomethacin, a PGE(2) synth esis inhibitor, on these lymphocyte functions in vitvo. In 36 previously un treated patients the lymphocyte functions were assayed before, 24 hours and seven days after the surgery. In regard to LPR, three distinct response pa tterns were observed: a) significant (p < 0.05) increase of initially lower ed LPR; b) significant (p < 0.001) decrease of initially normal LPR 24 hour s after operation, followed by normalization after seven days; c) no change of initially normal LPR. Indomethacin in vitvo significantly (p < 0.05) en hanced the diminished LPR only before surgery, no effect being seen after t he operation. The NK cell function was unaffected by surgery regardless the initial level of activity. Indomethacin had no effect on this lymphocyte f unction. There was no difference between the patient groups submitted to th e different anesthetic regimes. In conclusion, our results show that surgic al trauma variably affect the lymphocyte functions of cancer patients, the effect not being related to the particular anesthetic regime used. The PGE( 2)-mediated suppression is not likely to be involved in postoperative immun e function impairment.