Department of Emergency Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
J Pain Symptom Manage. 2013 Aug;46(2):161-72. doi: 10.1016/j.jpainsymman.2012.07.019. Epub 2012 Nov 11.
A report by the National Cancer Institute identified that an important gap in symptom research is the investigation of multiple symptoms of cancer that might identify common biological mechanisms among cancer-related symptoms.
We applied novel statistical methods to assess whether variants of 37 inflammation genes may serve as biologic markers of risk for severe pain, depressed mood, and fatigue in non-Hispanic white patients with non-small cell lung cancer.
Pain, fatigue, and depressed mood were assessed before cancer treatment. We used a generalized, multivariate, classification tree approach to explore the influence of single-nucleotide polymorphisms in the inflammation genes in pain, depressed mood, and fatigue in lung cancer patients.
Among patients with advanced-stage disease, interleukin (IL)-8-T251A was the most relevant genetic factor for pain (odds ratio [OR] = 2.18, 95% CI = 1.34-3.55, P = 0.001), depressed mood (OR = 0.37, 95% CI = 0.14-1.0), and fatigue (OR = 2.07, 95% CI = 1.16-3.70). Among those with early-stage non-small cell lung cancer, variants in the IL-10 receptor were relevant for fatigue among women. Specifically, women with Lys_Glu or Glu_Glu genotype in the IL-10 gene had a 0.49 times lower risk of severe fatigue compared with those with Lys_Lys genotype (OR = 0.49, 95% CI = 0.25-0.92, P = 0.027). Among men with early-stage lung cancer, a marginal significance was observed for IL-1A C-889T, C/T, or T/T genotypes. These men had a lower risk of severe fatigue compared with those with C/C genotype (OR = 0.38, 95% CI = 0.13-1.06).
The interaction of multiple inflammation genes, along with nongenetic factors, underlies the occurrence of symptoms. IL-8 and IL-10 may serve as potential targets for treating multiple symptoms of cancer.
美国国家癌症研究所的一份报告指出，症状研究中的一个重要空白是研究可能确定癌症相关症状之间共同生物学机制的多种癌症症状。
我们应用新的统计方法来评估 37 个炎症基因的变体是否可以作为非小细胞肺癌非裔美国白人患者严重疼痛、抑郁情绪和疲劳的风险的生物标志物。
在癌症治疗前评估疼痛、疲劳和抑郁情绪。我们使用广义的多变量分类树方法来探索炎症基因中的单核苷酸多态性对肺癌患者疼痛、抑郁情绪和疲劳的影响。
在晚期疾病患者中，白细胞介素（IL）-8-T251A 是疼痛（优势比[OR] = 2.18，95%置信区间[CI] = 1.34-3.55，P = 0.001）、抑郁情绪（OR = 0.37，95%CI = 0.14-1.0）和疲劳（OR = 2.07，95%CI = 1.16-3.70）的最相关遗传因素。在早期非小细胞肺癌患者中，IL-10 受体的变体与女性的疲劳相关。具体来说，与 Lys_Lys 基因型相比，IL-10 基因中 Lys_Glu 或 Glu_Glu 基因型的女性发生严重疲劳的风险降低了 0.49 倍（OR = 0.49，95%CI = 0.25-0.92，P = 0.027）。在早期肺癌男性中，IL-1A C-889T、C/T 或 T/T 基因型具有边缘显著性。与 C/C 基因型相比，这些男性发生严重疲劳的风险较低（OR = 0.38，95%CI = 0.13-1.06）。
多种炎症基因与非遗传因素的相互作用是发生症状的基础。IL-8 和 IL-10 可能是治疗癌症多种症状的潜在靶点。
