Zhou Yi, Gu Xiaohui, Wen Feng, Chen Jing, Wei Wen, Zhang Zhi-Hui, He Yanting, Xie Lan
The Department of Gynecology & Obstetrics,Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital,Chengdu,China.
Department of Geriatrics,Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital,Chengdu,China.
Int Psychogeriatr. 2016 Dec;28(12):2019-2028. doi: 10.1017/S1041610216001125. Epub 2016 Jul 29.
Cancer patients with depression or anxiety have poor survival, and the interaction between mental and physical problems in older patients may exacerbate this problem. K-ras oncogene (KRAS) mutation may play a role in the development of psychosocial distress and may be associated with poor survival of metastatic colorectal cancer (mCRC) patients. This study investigated the association between KRAS gene mutations and psychosocial morbidity to explore the possible cancer/psychosis relationship in older mCRC patients.
In this study, 62 newly diagnosed mCRC patients were recruited and completed the Hospital Anxiety and Depression Scale (HADS). Demographic data were also collected, and clinicopathological data were retrieved from medical records. KRAS mutations were assessed via PCR analysis of tissue specimens from the patients.
The results showed that 28 of the 62 participants (45.2%) had positive screens for possible depression, and 45 of the 62 participants (72.6%) had positive screens for anxiety. The KRAS mutation rate was 40.3% (25/62), and 19 of the 25 patients with KRAS mutations (76.0%) had probable depression, whereas only 24.3% of the patients with wild-type KRAS were probably depressed (p < 0.05). The KRAS mutation was associated with higher HADS depression scores, independent of gender and performance status (p < 0.05), but not with higher HADS anxiety or total scores.
KRAS mutations were associated with depression severity and higher rates of probable depression in older mCRC patients. Depression should be assessed and treated as early as possible in older mCRC patients with the KRAS mutation. Further studies are needed to verify our current findings using a larger sample size.
患有抑郁症或焦虑症的癌症患者生存率较低，老年患者心理和身体问题之间的相互作用可能会加剧这一问题。K-ras癌基因（KRAS）突变可能在社会心理困扰的发生发展中起作用，并且可能与转移性结直肠癌（mCRC）患者的低生存率相关。本研究调查了KRAS基因突变与社会心理发病率之间的关联，以探讨老年mCRC患者中可能存在的癌症/精神病关系。
在本研究中，招募了62例新诊断的mCRC患者，并完成了医院焦虑抑郁量表（HADS）。还收集了人口统计学数据，并从病历中检索临床病理数据。通过对患者组织标本进行PCR分析来评估KRAS突变。
结果显示，62名参与者中有28名（45.2%）可能患有抑郁症筛查呈阳性，62名参与者中有45名（72.6%）焦虑症筛查呈阳性。KRAS突变率为40.3%（25/62），25例KRAS突变患者中有19例（76.0%）可能患有抑郁症，而KRAS野生型患者中只有24.3%可能患有抑郁症（p<0.05）。KRAS突变与较高的HADS抑郁评分相关，与性别和体能状态无关（p<0.05），但与较高的HADS焦虑评分或总分无关。
KRAS突变与老年mCRC患者的抑郁严重程度和较高的可能抑郁症发生率相关。对于患有KRAS突变的老年mCRC患者，应尽早评估和治疗抑郁症。需要进一步研究以使用更大样本量验证我们目前的发现。
