Oliveira K G, von Zeidler S V, Lamas A Z, Podestá J R V de, Sena A, Souza E D, Lenzi J, Lemos E M, Gouvea S A, Bissoli N S
Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
Departamento de Patologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
Braz J Med Biol Res. 2014 Jul;47(7):600-4. doi: 10.1590/1414-431x20143599. Epub 2014 May 30.
Pain is a common symptom in patients with cancer, including those with head and neck cancer (HNC). While studies suggest an association between chronic inflammation and pain, levels of inflammatory cytokines, such as C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), have not been correlated with pain in HNC patients who are not currently undergoing anticancer treatment. The purpose of this study was to examine the relationship between these inflammatory markers and perceived pain in HNC patients prior to anticancer therapy. The study group consisted of 127 HNC patients and 9 healthy controls. Pain was assessed using the Brief Pain Inventory (BPI), and serum levels of CRP and TNF-α were determined using the particle-enhanced turbidimetric immunoassay (PETIA) and ELISA techniques, respectively. Patients experiencing pain had significantly higher levels of CRP (P<0.01) and TNF-α (P<0.05) compared with controls and with patients reporting no pain. There were significantly positive associations between pain, CRP level, and tumor stage. This is the first study to report a positive association between perceived pain and CRP in HNC patients at the time of diagnosis. The current findings suggest important associations between pain and inflammatory processes in HNC patients, with potential implications for future treatment strategies.
疼痛是癌症患者（包括头颈癌患者）的常见症状。虽然研究表明慢性炎症与疼痛之间存在关联，但在目前未接受抗癌治疗的头颈癌患者中，炎症细胞因子如C反应蛋白（CRP）和肿瘤坏死因子-α（TNF-α）的水平与疼痛并无相关性。本研究的目的是探讨这些炎症标志物与头颈癌患者在接受抗癌治疗前的疼痛感知之间的关系。研究组由127名头颈癌患者和9名健康对照组成。使用简明疼痛问卷（BPI）评估疼痛，并分别采用颗粒增强比浊免疫分析法（PETIA）和酶联免疫吸附测定（ELISA）技术测定血清CRP和TNF-α水平。与对照组及无疼痛报告的患者相比，有疼痛的患者CRP水平（P<0.01）和TNF-α水平（P<0.05）显著更高。疼痛、CRP水平与肿瘤分期之间存在显著正相关。这是第一项报告头颈癌患者在诊断时疼痛感知与CRP呈正相关的研究。目前的研究结果表明头颈癌患者的疼痛与炎症过程之间存在重要关联，对未来的治疗策略可能具有潜在意义。
