Boermeester M A, Butzelaar R M
Sint Lucas Andreas Ziekenhuis, afd. Chirurgie, Amsterdam.
Ned Tijdschr Geneeskd. 1999 Apr 17;143(16):838-42.
Awareness of the interactive relation between psychosocial stressors, neuroendocrine and immunological processes, and tumour progression in patients with breast cancer appears to be important for clinicians. However, it is not established yet how the available knowledge can be applied therapeutically. Hormonal factors play a part in the carcinogenesis of breast cancer. Growth of the breast tumour is influenced by endocrine hormones. Antioestrogen therapy is effective in the treatment of breast cancer. Several components of the immune system are related to the course of disease in breast cancer patients. Psychosocial stressors influence neuroendocrine (corticotrophin-releasing hormone (CRH), cortisol, oestrogen) and immunological functions. Psychosocial stressors may be linked to recurrence or survival. Certain coping mechanisms (even those of a negative nature) and the social network of the patient may have prognostic values. Since recurrence of the disease is still possible many years after curative surgery, multifactorial effects on the course of disease are likely.
对于临床医生而言,了解心理社会应激源、神经内分泌和免疫过程以及乳腺癌患者肿瘤进展之间的相互关系似乎很重要。然而,目前尚未确定如何将现有知识应用于治疗。激素因素在乳腺癌的致癌过程中起作用。乳腺肿瘤的生长受内分泌激素影响。抗雌激素疗法在乳腺癌治疗中有效。免疫系统的几个组成部分与乳腺癌患者的病程相关。心理社会应激源会影响神经内分泌(促肾上腺皮质激素释放激素(CRH)、皮质醇、雌激素)和免疫功能。心理社会应激源可能与复发或生存相关。某些应对机制(即使是负面性质的)以及患者的社会网络可能具有预后价值。由于在根治性手术后许多年疾病仍有可能复发,因此对病程的多因素影响很可能存在。