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乳腺癌幸存者的童年逆境与炎症

Childhood adversity and inflammation in breast cancer survivors.

作者信息

Crosswell Alexandra D, Bower Julienne E, Ganz Patricia A

机构信息

UCLA Departments of Psychology (A.D.C., J.E.B.) and Psychology and Psychiatry & Biobehavioral Sciences (J.E.B.), Schools of Medicine & Public Health, and the Jonsson Comprehensive Cancer Center (P.A.G.), Los Angeles, California.

出版信息

Psychosom Med. 2014 Apr;76(3):208-14. doi: 10.1097/PSY.0000000000000041.

Abstract

OBJECTIVE

Elevated inflammation predicts behavioral symptoms, disease progression, and mortality in patients with breast cancer and breast cancer survivors, although predictors of inflammation remain largely unknown. Adverse experiences in childhood have been associated with higher rates of psychological and physical illness, and elevated inflammatory activity in studies of healthy adults. However, little research has examined the association between childhood adversity and inflammation in the context of cancer, where inflammation is particularly relevant for health.

METHODS

The current study examined the association between three types of childhood adversity--abuse, neglect, and a chaotic home environment--and inflammatory markers (interleukin [IL]-6 and C-reactive protein), in breast cancer survivors who had completed primary cancer treatment 1 year earlier (n = 152).

RESULTS

The combined measure of childhood adversity was associated with elevations in plasma levels of IL-6 (B = 0.009, p = .027, η2 = 0.027, after controlling for age, body mass index, ethnicity, alcohol use, and cancer treatment (surgery, radiation, and/or chemotherapy). Examination of individual types of adversity demonstrated a positive association between abuse and IL-6 (B = 0.043, p = .030, η = 0.026), chaotic home environment and IL-6 (B = 0.031, p = .005, η = 0.043), and chaotic home environment and soluble tumor necrosis factor receptor type II (B = 0.012, p = .009, η2 = 0.037), after controlling for relevant confounds.

CONCLUSION

Childhood adversity was associated with elevated markers of inflammation in breast cancer survivors, with potential negative implications for health and well-being. In particular, chaotic home environment showed unique links with inflammatory outcomes.

摘要

目的

炎症水平升高预示着乳腺癌患者及乳腺癌幸存者的行为症状、疾病进展和死亡率,尽管炎症的预测因素在很大程度上仍不明确。童年时期的不良经历与心理和身体疾病的高发病率以及健康成年人研究中炎症活动的增强有关。然而,在癌症背景下,很少有研究探讨童年逆境与炎症之间的关联,而炎症在癌症中与健康尤为相关。

方法

本研究调查了1年前完成原发性癌症治疗的乳腺癌幸存者(n = 152)中三种童年逆境类型——虐待、忽视和混乱的家庭环境——与炎症标志物(白细胞介素[IL]-6和C反应蛋白)之间的关联。

结果

在控制了年龄、体重指数、种族、饮酒情况和癌症治疗(手术、放疗和/或化疗)后,童年逆境的综合指标与血浆IL-6水平升高有关(B = 0.009,p = 0.027,η2 = 0.027)。对个体逆境类型的研究表明,在控制了相关混杂因素后,虐待与IL-6之间存在正相关(B = 0.043,p = 0.030,η = 0.026),混乱的家庭环境与IL-6之间存在正相关(B = 0.031,p = 0.005,η = 0.043),混乱的家庭环境与可溶性肿瘤坏死因子受体II型之间存在正相关(B = 0.012,p = 0.009,η2 = 0.037)。

结论

童年逆境与乳腺癌幸存者炎症标志物升高有关,对健康和幸福可能产生负面影响。特别是,混乱的家庭环境与炎症结果显示出独特的联系。

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