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乳腺癌治疗效果的初步研究:免疫标志物与生活质量和神经心理学表现的关系。

Preliminary study on the effects of treatment for breast cancer: immunological markers as they relate to quality of life and neuropsychological performance.

机构信息

Department of Neurology & Ophthalmology, Michigan State University, East Lansing, USA.

Department of Psychiatry, 909 Wilson Road, Rm 327, West Fee Hall, East Lansing Michigan, East Lansing, MI, 48824, USA.

出版信息

BMC Womens Health. 2020 May 20;20(1):109. doi: 10.1186/s12905-020-00971-1.

Abstract

BACKGROUND

Immunological biomarkers were related to quality of life and neuropsychological performance in women recently diagnosed with breast cancer through the first six months of treatment. A comparison group of breast cancer survivors in remission were also evaluated.

METHOD

Twenty women newly diagnosed with breast cancer and 26 breast cancer survivors at least a year after treatment were evaluated four times over a course of six to 8 months. The assessments included quality-of-life, emotional and spiritual well-being, sleep quality, computerized neuropsychological performance, and cytokine immunology biomarkers using flow cytometry. The principal immunological markers examined were the CD4+, CD8+, and CD16+ counts.

RESULTS

Although equivalent at enrollment, active treatment women reported higher anxiety, depression, poorer quality-of-life, and poorer processing speed and accuracy on memory, logical processes, and coding neuropsychological tasks. They also had significantly higher CD8+ and CD16+ cell count levels during treatment over the next six to eight months than comparison group women in remission. Women undergoing chemotherapy as well during treatment phase also had a significant decline in CD4+ counts. Higher percent CD8+ levels during treatment was associated with poorer quality of life and more depression, while higher CD4+ and CD8+ were associated with poorer neuropsychological memory and processing speed performance.

CONCLUSION

Significant increases in CD8+ is a sensitive biomarker of a broad range of poorer quality-of-life and neurocognitive functioning outcomes during breast cancer treatment, especially in women undergoing chemotherapy. Quality of life should be monitored in breast cancer patients and psychosocial support made available as a standard of care.

摘要

背景

免疫生物标志物与近期诊断为乳腺癌的女性在治疗的头六个月内的生活质量和神经心理表现有关。还评估了一组处于缓解期的乳腺癌幸存者作为对照组。

方法

20 名新诊断为乳腺癌的女性和 26 名乳腺癌幸存者在治疗后至少一年被评估了四次,共 6-8 个月。评估包括生活质量、情绪和精神健康、睡眠质量、计算机神经心理表现以及使用流式细胞术的细胞因子免疫生物学标志物。检查的主要免疫标志物是 CD4+、CD8+和 CD16+计数。

结果

尽管在入组时相当,但接受积极治疗的女性报告了更高的焦虑、抑郁、更差的生活质量,以及在记忆、逻辑处理和编码神经心理任务上的处理速度和准确性更差。在接下来的六到八个月的治疗期间,与处于缓解期的对照组女性相比,她们的 CD8+和 CD16+细胞计数水平也显著升高。在治疗阶段也接受化疗的女性在治疗期间也出现 CD4+计数显著下降。治疗期间较高的 CD8+百分比与较差的生活质量和更多的抑郁有关,而较高的 CD4+和 CD8+与较差的神经心理记忆和处理速度表现有关。

结论

在乳腺癌治疗期间,CD8+的显著增加是广泛的生活质量和神经认知功能结果较差的敏感生物标志物,特别是在接受化疗的女性中。应该监测乳腺癌患者的生活质量,并提供社会心理支持作为标准护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b078/7238579/1bec7c63451c/12905_2020_971_Fig1_HTML.jpg

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