Laird Barry J, McMillan Donald C, Fayers Peter, Fearon Kenneth, Kaasa Stein, Fallon Marie T, Klepstad Pål
European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim, Norway;
Oncologist. 2013;18(9):1050-5. doi: 10.1634/theoncologist.2013-0120. Epub 2013 Aug 21.
Inflammation has been identified as a hallmark of cancer and may be necessary for tumorgenesis and maintenance of the cancer state. Inflammation-related symptoms are common in those with cancer; however, little is known about the relationship between symptoms and systemic inflammation in cancer. The aim of the present study was to examine the relationship between symptoms and systemic inflammation in a large cohort of patients with advanced cancer.
Data from an international cohort of patients with advanced cancer were analyzed. Symptoms and patient-related outcomes were recorded using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire--Core Questionnaire. Systemic inflammation was assessed using C-reactive protein levels. The relationship between these symptoms and systemic inflammation was examined using Spearman rank correlation (ρ) and the Mann-Whitney U test.
Data were available for 1,466 patients across eight European countries; 1,215 patients (83%) had metastatic disease at study entry. The median survival was 3.8 months (interquartile range [IQR] 1.3-12.2 months). The following were associated with increased levels of inflammation: performance status (ρ = .179), survival (ρ = .347), pain (ρ = .154), anorexia (ρ = .206), cognitive dysfunction (ρ = .137), dyspnea (p= .150), fatigue (ρ = .197), physical dysfunction (ρ = .207), role dysfunction (ρ = .176), social dysfunction (ρ = .132), and poor quality of life (ρ = .178). All were statistically significant at p < .001.
The results show that the majority of cancer symptoms are associated with inflammation. The strength of the potential relationship between systemic inflammation and common cancer symptoms should be examined further within the context of an anti-inflammatory intervention trial.
炎症已被确认为癌症的一个标志，可能是肿瘤发生和维持癌症状态所必需的。炎症相关症状在癌症患者中很常见；然而，对于癌症中症状与全身炎症之间的关系知之甚少。本研究的目的是在一大群晚期癌症患者中检查症状与全身炎症之间的关系。
分析了来自一个国际晚期癌症患者队列的数据。使用欧洲癌症研究与治疗组织生活质量问卷核心问卷记录症状和患者相关结局。使用C反应蛋白水平评估全身炎症。使用Spearman等级相关性（ρ）和Mann-Whitney U检验检查这些症状与全身炎症之间的关系。
来自八个欧洲国家的1466名患者的数据可用；1215名患者（83%）在研究开始时患有转移性疾病。中位生存期为3.8个月（四分位间距[IQR]1.3 - 12.2个月）。以下因素与炎症水平升高相关：体能状态（ρ = 0.179）、生存期（ρ = 0.347）、疼痛（ρ = 0.154）、厌食（ρ = 0.206）、认知功能障碍（ρ = 0.137）、呼吸困难（p = 0.150）、疲劳（ρ = 0.197）、身体功能障碍（ρ = 0.20）、角色功能障碍（ρ = 0.176）、社会功能障碍（ρ = 0.132）和生活质量差（ρ = 0.178）。所有这些在p < 0.001时均具有统计学意义。
结果表明，大多数癌症症状与炎症相关。全身炎症与常见癌症症状之间潜在关系的强度应在抗炎干预试验的背景下进一步研究。
