Childhood adversity and inflammation in breast cancer survivors.
Childhood adversity and inflammation in breast cancer survivors.
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DOI：
10.1097/psy.0000000000000041
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发表时间：
2014-04
影响因子：
3.3
通讯作者：
Ganz PA
中科院分区：
文献类型：
--
作者：
Crosswell AD;Bower JE;Ganz PA
炎症升高可以预测乳腺癌患者和乳腺癌幸存者的行为症状、疾病进展和死亡率，尽管炎症的预测因素在很大程度上仍不清楚。在健康成年人的研究中，童年时期的不良经历与较高的心理和身体疾病发生率以及炎性活动增加有关。然而，很少有研究在癌症的背景下考察童年逆境和炎症之间的联系，而癌症中的炎症与健康特别相关。目前的研究调查了三种类型的童年逆境-虐待、忽视和混乱的家庭环境-与炎症标记物(白介素[IL]-6和C-反应蛋白)之间的关系，这些患者在一年前完成了初级癌症治疗(n=152)。在控制了年龄、体重指数、种族、饮酒和癌症治疗(手术、放疗和/或化疗)后，儿童逆境的综合衡量与血浆IL-6水平的升高有关(B=0.009，p=.027，η2=0.027)。对个体逆境类型的研究表明，在控制相关混杂因素后，虐待与IL-6(B=0.043，p=.030，η2=0.026)、混乱的家庭环境与IL-6(B=0.031，p=.005，η2=0.043)、混乱的家庭环境与可溶性肿瘤坏死因子受体II型(B=0.012，p=.009，η2=0.037)呈正相关。童年的逆境与乳腺癌幸存者体内炎症标志物的升高有关，对健康和福祉有潜在的负面影响。特别是，混乱的家庭环境与炎症结果显示出独特的联系。
Elevated inflammation predicts behavioral symptoms, disease progression, and mortality in patients with breast cancer and breast cancer survivors, although predictors of inflammation remain largely unknown. Adverse experiences in childhood have been associated with higher rates of psychological and physical illness, and elevated inflammatory activity in studies of healthy adults. However, little research has examined the association between childhood adversity and inflammation in the context of cancer, where inflammation is particularly relevant for health. The current study examined the association between three types of childhood adversity—abuse, neglect, and a chaotic home environment—and inflammatory markers (interleukin [IL]-6 and C-reactive protein), in breast cancer survivors who had completed primary cancer treatment 1 year earlier (n = 152). The combined measure of childhood adversity was associated with elevations in plasma levels of IL-6 (B = 0.009, p = .027, η2 = 0.027, after controlling for age, body mass index, ethnicity, alcohol use, and cancer treatment (surgery, radiation, and/or chemotherapy). Examination of individual types of adversity demonstrated a positive association between abuse and IL-6 (B = 0.043, p = .030, η2 = 0.026), chaotic home environment and IL-6 (B = 0.031, p = .005, η2 = 0.043), and chaotic home environment and soluble tumor necrosis factor receptor type II (B = 0.012, p = .009, η2 = 0.037), after controlling for relevant confounds. Childhood adversity was associated with elevated markers of inflammation in breast cancer survivors, with potential negative implications for health and well-being. In particular, chaotic home environment showed unique links with inflammatory outcomes.