Oncologic Center (Onkologikoa), 121 Beguiristain, 20014 San Sebastian, Spain.
Department of Basic Psychological Processes and their Development, University of The Basque Country, 70 Tolosa Av., 20018 San Sebastian, Spain.
Physiol Behav. 2021 Mar 1;230:113297. doi: 10.1016/j.physbeh.2020.113297. Epub 2020 Dec 19.
To examine the extent to which anxiety and depressive symptoms, self-esteem and proinflammatory cytokines interact to significantly predict quality of life in breast cancer survivors.
Cross-sectional data were collected from 134 breast cancer survivors. Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale and Quality of Life in Adult Cancer Survivors questionnaire, which includes the generic quality of life (QOL) and the quality of life related to cancer (QOLRC) subscales, were administered. Plasma IL-6 and TNF-α levels were measured using ELISA kits. Moderation analyses were performed to study the influence of psychobiological variables on quality of life.
Anxiety and depressive symptoms, TNF-α predicted QOL scores, and both medium and high levels of TNF-α influenced the negative conditional effect of depressive symptoms on QOL. Anxiety symptoms and TNF-α was associated with QOLRC scores, and lower self-esteem predicted poorer QOLRC when women had high levels of TNF-α.
These results highlight the booster effect of TNF-α for poorer quality of life in breast cancer survivors, both alone and in combination with depressive symptoms or low self-esteem. The study provides a framework for assessing subclinical markers, identifying vulnerable survivors and implementing psychological strategies to improve quality of life.
探讨焦虑和抑郁症状、自尊和促炎细胞因子在多大程度上相互作用，显著预测乳腺癌幸存者的生活质量。
从 134 名乳腺癌幸存者中收集了横断面数据。采用医院焦虑抑郁量表、罗森伯格自尊量表和成人癌症幸存者生活质量问卷，包括通用生活质量（QOL）和与癌症相关的生活质量（QOLRC）子量表。使用 ELISA 试剂盒测量血浆 IL-6 和 TNF-α 水平。进行调节分析以研究心理生物学变量对生活质量的影响。
焦虑和抑郁症状、TNF-α 预测了 QOL 评分，并且 TNF-α 的中高水平影响了抑郁症状对 QOL 的负条件效应。焦虑症状和 TNF-α与 QOLRC 评分相关，当女性 TNF-α 水平较高时，较低的自尊预示着 QOLRC 较差。
这些结果突出了 TNF-α对乳腺癌幸存者生活质量的负面影响，无论是单独作用还是与抑郁症状或低自尊结合作用。该研究为评估亚临床标志物、识别脆弱幸存者和实施改善生活质量的心理策略提供了框架。
