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Chapter 16. Local Anesthetics, Regional Anesthesia, and Cancer Recurrence
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Which of the following statements is true regarding the perioperative period and immune modulation?
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A. Hypotension and hypovolemia at the time of surgery may influence the immune balance of cancer patients in a deleterious fashion predisposing to cancer cell metastasis.
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B. Hypotension and hypovolemia may influence immune modulation by increasing the Th1 (T helper 1) response.
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C. Th2-type immune responses are necessary for antitumor immunity.
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D. NK cells have a crucial role in the propagation of metastases in the perioperative period.
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A is correct. Hypotension and hypovolemia at the time of surgery may influence the immune balance of cancer patients in a deleterious fashion predisposing to cancer cell metastasis.
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B is incorrect. Hypotension and hypovolemia may influence immune modulation in the perioperative period by suppressing the Th1 response, thereby shifting the balance in favor of Th2.
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C is incorrect. Th1 response is the immune response necessary for antitumor immunity.
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D is incorrect. NK cells have a crucial role in antitumor immunity.
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Which of the following statements is true regarding the Th1 to Th2 ratio and role in the development of cancer metastasis?
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A. The natural killer (NK), CD4+ Th1 (T helper 1), and CD8+ CTL (cytotoxic lymphocyte) cells are the most important cells in the promotion of tumor growth and metastasis.
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B. Th2 (T helper 2), tumor-associated macrophages (TAM), and regulatory T (Treg) cells are among the major antitumor immune effector cells.
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C. NK cells have a crucial role, particularly in eliminating metastases without prior sensitization and major histocompatibility complex (MHC) restriction.
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D. NK cell function can be upregulated by prostaglandins, especially prostaglandin E2 (PGE2), shifting the cytokine balance toward Th2 dominance and promoting tumor angiogenesis.
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E. Proinflammatory cytokines (IL-6, tumor necrosis factor alpha [TNF-α], IL-13) released from infiltrating leukocytes close to the primary tumor site can activate nuclear factor κB (NF-κB) and STAT3 in cancer cells and thus inhibit tumor growth and proliferation.
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C is correct. NK cells have a crucial role, particularly in eliminating metastases without prior sensitization and major histocompatibility complex (MHC) restriction.
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A is incorrect. The natural killer (NK), CD4+ Th1 (T helper 1), and CD8+ CTL (cytotoxic lymphocyte) cells are the major antitumor immune effector cells.
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B is incorrect. Th2 (T helper 2), tumor-associated macrophages (TAM), and regulatory T (Treg) cells are among the most important ...