Gidron Yori, Ronson Alain
Brunel University, Uxbridge, Middlesex, UK bInstitute of Jules Bordet, The Free University of Brussels, Brussels, Belgium.
Curr Opin Oncol. 2008 Jul;20(4):386-92. doi: 10.1097/CCO.0b013e3282fbcd0d.
The present article briefly reviews the prognostic role of psychosocial factors in cancer and concentrates on biological markers that may mediate such relationships. We focus on specific markers that show promising mediating roles.
The article reviews the prognostic role of psychosocial factors as shown in longitudinal studies and in previous reviews. We present the general stress response and its relevance to cancer progression. The main focus of the article is on the prognostic roles of specific biomarkers that had to meet three criteria for being accepted as biomarkers - being related to a psychosocial factor at the level of the brain, the circulation, and the tissue/cellular level. We review studies supporting the mediating roles of neurohormones and neurotransmitters (e.g., cortisol, norepinephrine), the vagal nerve and inflammation, interleukin-1, DNA damage, and the hormone oxytocin.
These biomarkers may mediate the relationships between certain psychosocial factors (e.g., hopelessness, social support) and cancer progression. Future studies should test the effects of altering such biomarkers on the prognosis of patients scoring high/low on their associated psychosocial factors. Clinical implications that need to be tested are provided.
本文简要回顾心理社会因素在癌症中的预后作用，并着重探讨可能介导此类关系的生物标志物。我们聚焦于显示出有前景的介导作用的特定标志物。
本文回顾了纵向研究及以往综述中所显示的心理社会因素的预后作用。我们阐述了一般应激反应及其与癌症进展的相关性。本文的主要重点是特定生物标志物的预后作用，这些生物标志物必须满足被认定为生物标志物的三个标准——在大脑、循环系统以及组织/细胞水平上与心理社会因素相关。我们回顾了支持神经激素和神经递质（如皮质醇、去甲肾上腺素）、迷走神经与炎症、白细胞介素 -1、DNA 损伤以及激素催产素介导作用的研究。
这些生物标志物可能介导某些心理社会因素（如绝望感、社会支持）与癌症进展之间的关系。未来研究应测试改变此类生物标志物对在相关心理社会因素上得分高/低的患者预后的影响。文中提供了有待测试的临床意义。
