Postsurgical Depressive Symptoms and Proinflammatory Cytokine Elevations in Women Undergoing Primary Treatment for Breast Cancer.
Postsurgical Depressive Symptoms and Proinflammatory Cytokine Elevations in Women Undergoing Primary Treatment for Breast Cancer.
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DOI：
10.1097/psy.0000000000000261
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发表时间：
2016-01
影响因子：
3.3
通讯作者：
Carver CS
中科院分区：
文献类型：
--
作者：
Bouchard LC;Antoni MH;Blomberg BB;Stagl JM;Gudenkauf LM;Jutagir DR;Diaz A;Lechner S;Glück S;Derhagopian RP;Carver CS
抑郁和炎症可能独立促进乳腺癌（BCa）疾病进展和较差的临床结果。抑郁症与健康个体和癌症患者的炎症标志物水平升高有关。然而，研究时间范围的不一致使特定癌症类型内结果的解释变得复杂。这项研究探讨了早期 BCa 女性在开始辅助治疗之前抑郁症状与炎症之间的关系。手术后约 4-8 周招募患有 0-III 期 BCa 的女性。使用汉密尔顿抑郁量表评估抑郁症状，并收集血液样本，通过 ELISA 定量 IL-1β、IL-6 和 TNF-α 的循环水平。 ANCOVA 用于测试细胞因子水平的组间差异（抑郁症状升高与降低）。使用多元回归分析来检查抑郁症状的连续严重程度与调整相关生物行为协变量的细胞因子水平之间的关系。 89 名患者中有 36 名 (40%) 表现出抑郁症状水平升高，并且在调整后的模型中，IL-1β 水平略高（M=14.49, 95% CI [6.11, 32.65] 对比 M=4.68, 95% CI [1.96, 9.86]），TNF-α 水平显着升高（M=17.07, 95% CI [6.11, 32.65]） [8.27, 34.32] vs. M=6.94, 95% CI [3.58, 12.80]）高于抑郁症状较低的女性。在所有抑郁症状中，更严重的抑郁症状与更高水平的 IL-1β（β=0.06，p=0.006，R2=0.25）和 TNF-α（β=0.06，p=0.003，R2=0.27）相关。早期 BCa 的术后和辅助治疗前，抑郁症状伴随着多种促炎细胞因子水平的升高。研究结果对同时关注抑郁症和炎症的心理社会和生物干预措施具有影响。
Depression and inflammation may independently promote breast cancer (BCa) disease progression and poorer clinical outcomes. Depression has been associated with increased levels of inflammatory markers in medically healthy individuals and cancer patients. However, inconsistencies in study time frames complicate interpretation of results within specific cancer types. This study examined relationships between depressive symptoms and inflammation in women with early stage BCa before beginning adjuvant treatment. Women with stage 0–III BCa were recruited approximately 4–8 weeks post-surgery. Depressive symptoms were assessed using the Hamilton Rating Scale for Depression and blood samples were collected to quantify circulating levels of IL-1β, IL-6, and TNF-α by ELISA. ANCOVAs were used to test for group differences (elevated vs. low depressive symptoms) in levels of cytokines. Multiple regression analyses were used to examine relationships between continuous severity of depressive symptoms and levels of cytokines adjusting for relevant biobehavioral covariates. Thirty-six of 89 (40%) patients showed elevated levels of depressive symptoms, and in adjusted models had marginally higher levels of IL-1β (M=14.49, 95% CI [6.11, 32.65] vs. M=4.68, 95% CI [1.96, 9.86]) and significantly higher levels of TNF-α (M=17.07, 95% CI [8.27, 34.32] vs. M=6.94, 95% CI [3.58, 12.80]) than women with low depressive symptoms. Across the spectrum of depressive symptoms, greater magnitude of depressive symptoms was related to greater levels of IL-1β (β=0.06, p=0.006, R2=0.25) and TNF-α (β=0.06, p=0.003, R2=0.27). Post-surgery and pre-adjuvant treatment for early stage BCa, depressive symptoms covary with elevated levels of multiple pro-inflammatory cytokines. Findings have implications for psychosocial and biological interventions concurrently focusing on depression and inflammation.