{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:58:38Z","timestamp":1785419918937,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To investigate the early effect of esketamine on the tumor metastatic microenvironment in patients with lung cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixteen adults aged 45\u201380\u2009years with the American Society of Anesthesiologists (ASA) 1 to 3 were randomly divided into the experimental group (group E) and the control group (group C). Group E received esketamine at 1\u2009mg\/kg during anesthesia induction and a continuous infusion of 0.5\u2009mg\/kg\/h during the surgery. Group C was given the same amount of normal saline infusion. Patient\u2010controlled intravenous analgesia (PCIA) in group E was administered using dexmedetomidine (0.5\u2009mg\/kg)\u2009+\u2009esketamine (50\u2009mg)\u2009+\u2009dexamethasone (5\u2009mg). PCIA in group C was the same dose of dexmedetomidine and dexamethasone. Data were recorded at 14 points from admission to the third day after surgery (T<jats:sub>0\u201314<\/jats:sub>). Parameters recorded included hemodynamics, wake time, remifentanil dosage, and so on. At T<jats:sub>0<\/jats:sub>, T<jats:sub>10<\/jats:sub>, T<jats:sub>13<\/jats:sub>, and T<jats:sub>14<\/jats:sub>, TNF\u2010\u03b1, IL\u20102, IL\u201010, MMP\u20109, and VEGF\u2010C were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with T<jats:sub>0<\/jats:sub>, the differences of tumor necrosis factor\u2010\u03b1 (TNF\u2010\u03b1), interleukin\u20102 (IL\u20102), matrix metallopeptidase 9 (MMP\u20109), and vascular endothelial growth factor\u2010C (VEGF\u2010C) in the two groups were statistically significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). When compared to group C, VEGF\u2010C in group E was reduced at T<jats:sub>10<\/jats:sub> and T<jats:sub>13<\/jats:sub> (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). For both groups, there were intragroup differences in the changes of MMP\u20109 and VEGF\u2010C levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Compared to group C, on the postoperative, group E exhibited a lower change rate of TNF\u2010\u03b1 and VEGF\u2010C (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Perioperative application of esketamine in patients with lung cancer provided significant sedative and analgesic effects and affected cytokines in the tumor microenvironment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.70108","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T04:55:16Z","timestamp":1755147316000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Early Effects of Esketamine on the Tumor Metastatic Microenvironment in Postoperative Lung Cancer Patients"],"prefix":"10.1111","volume":"19","author":[{"given":"Yong","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology The Forth Hospital of 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