Division of Clinical Neurosciences, School of Medicine, University of Southampton, Royal South Hants Hospital, Brinton’s Terrace, Southampton, United Kingdom.
Psychosom Med. 2010 Nov;72(9):912-6. doi: 10.1097/PSY.0b013e3181f0bc1c. Epub 2010 Aug 17.
To investigate the association of serum levels of proangiogenic cytokines with different indices of social support and loneliness by measuring the levels of expression of two important proangiogenic cytokines, vascular endothelial growth factor (VEGF), and interleukin-6 in tumors of colon and rectum. Lack of social support has been prospectively associated with cancer progression.
Fifty-one newly diagnosed patients with colorectal tumors (mean age, 68.3 years) completed two measures of loneliness 1 to 2 days before their surgical treatment. The first was an explicit self-report questionnaire, which tapped into negative feelings as a result of low social support. The second was a standardized computer-based task, which measured loneliness implicitly. Immunohistochemical analyses were performed on tumor tissues post surgery to determine the expression of cytokines.
Logistic regression showed that higher levels of implicit loneliness independently predicted stronger expression of VEGF, controlling for Dukes stage and explicit loneliness, both of which were nonsignificant predictors. No significant relationships were found between the loneliness measures and interleukin-6.
The results of this study suggest VEGF to be an angiogenic mechanism through which loneliness may lead to worse cancer-related outcomes. Implications are discussed in terms of devising targeted psychosocial and immunotherapeutic interventions for cancer patients with low social support.
通过测量两种重要的促血管生成细胞因子血管内皮生长因子 (VEGF) 和白细胞介素 6 在结肠和直肠肿瘤中的表达水平,研究血清中促血管生成细胞因子与不同社会支持和孤独感指标的关系。缺乏社会支持已被前瞻性地与癌症进展相关联。
51 名新诊断为结直肠肿瘤的患者(平均年龄 68.3 岁)在手术治疗前 1 至 2 天完成了两项孤独感测量。第一项是一项明确的自我报告问卷,它揭示了由于社会支持不足而产生的负面感受。第二项是基于计算机的标准化任务,它隐式测量孤独感。手术后对肿瘤组织进行免疫组织化学分析,以确定细胞因子的表达。
逻辑回归显示,在控制 Dukes 分期和明确的孤独感后,更高水平的隐性孤独感独立地预测了 VEGF 的更强表达,而这两者都不是显著的预测因子。孤独感测量与白细胞介素 6 之间没有显著关系。
本研究的结果表明,VEGF 是孤独感可能导致更差的癌症相关结局的一种血管生成机制。根据为社会支持低的癌症患者设计有针对性的心理社会和免疫治疗干预措施,对结果进行了讨论。