Navarro-Martínez Rut, Serrano-Carrascosa María, Buigues Cristina, Fernández-Garrido Julio, Sánchez-Martínez Vanessa, Castelló-Domenech Ana B, García-Villodre Laura, Wong-Gutiérrez Augusto, Rubio-Briones José, Cauli Omar
Department of Nursing, University of Valencia, Valencia, Spain; Department of Haematology, Hospital General Universitario, Valencia, Spain.
Department of Urology, Fundación IVO, Valencia, Spain.
Urol Oncol. 2019 Dec;37(12):976-987. doi: 10.1016/j.urolonc.2019.08.005. Epub 2019 Sep 12.
To evaluate the role of peripheral inflammation (leukocyte differential count, the proinflammatory cytokines IL-beta, TNF-α, IL-6, IL-8, and the inflammatory markers fibrinogen and C-reactive protein [CRP]) in frailty syndrome in patients with prostate cancer (CaP) undergoing antiandrogen therapy (ADT).
A total of 46 men between 51 and 92 years of age with CaP and receiving ADT were classified as frail, prefrail or robust according to the Fried scale. A geriatric assessment was performed, based on the Minimental State Examination for cognitive function, the Barthel index for basic activities of daily living, the Yesavage scale for geriatric depression, and the Athens insomnia scale. In addition, blood samples were collected to assess peripheral inflammation biomarkers including proinflammatory cytokines, fibrinogen, CRP and leukocyte differential count, as well as other biochemical and hematological parameters.
A significant negative correlation between the severity of frailty syndrome and lymphocyte count was observed (P < 0.01). The concentration of IL-6 (P < 0.05), CRP (P < 0.05), and fibrinogen (P < 0.01) were significantly associated with frailty syndrome, but not of TNF-α, IL-beta, or IL-8. The severity of frailty syndrome was not dependent upon the clinical disease stage at diagnosis, the time elapsed since CaP diagnosis, the presence of metastases, or prostatectomy.
Further research into the role of leukocyte subtypes and peripheral inflammation and the associated adverse outcomes in patients with CaP under ADT is warranted in order to tailor interventions aimed at reducing symptoms of frailty syndrome, such as loss of muscle strength and low physical activity.
评估外周炎症（白细胞分类计数、促炎细胞因子白细胞介素-β、肿瘤坏死因子-α、白细胞介素-6、白细胞介素-8以及炎症标志物纤维蛋白原和C反应蛋白[CRP]）在接受抗雄激素治疗（ADT）的前列腺癌（CaP）患者虚弱综合征中的作用。
根据Fried量表，将46名年龄在51至92岁之间、患有CaP且正在接受ADT的男性分为虚弱、衰弱前期或强壮组。基于简易精神状态检查表评估认知功能、巴氏指数评估日常生活基本活动、Yesavage量表评估老年抑郁以及雅典失眠量表进行老年评估。此外，采集血样以评估外周炎症生物标志物，包括促炎细胞因子、纤维蛋白原、CRP和白细胞分类计数，以及其他生化和血液学参数。
观察到虚弱综合征严重程度与淋巴细胞计数之间存在显著负相关（P < 0.01）。白细胞介素-6（P < 0.05）、CRP（P < 0.05）和纤维蛋白原（P < 0.01）的浓度与虚弱综合征显著相关，但肿瘤坏死因子-α、白细胞介素-β或白细胞介素-8与虚弱综合征无关。虚弱综合征的严重程度不取决于诊断时的临床疾病分期、自CaP诊断以来经过的时间、转移灶的存在或前列腺切除术。
有必要进一步研究白细胞亚型和外周炎症的作用以及ADT治疗的CaP患者的相关不良结局，以便制定旨在减轻虚弱综合征症状（如肌肉力量丧失和身体活动不足）的干预措施。
