Ho Hsing-Ying, Chin-Hung Chen Vincent, Tzang Bor-Show, Hsieh Ching-Chuan, Wang Wen-Ke, Weng Yi-Ping, Hsu Ya-Ting, Hsaio Han-Pin, Weng Jun-Cheng, Chen Yi-Lung
Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi City, 613, Taiwan.
Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi City, 613, Taiwan; School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
J Psychiatr Res. 2021 Apr;136:306-311. doi: 10.1016/j.jpsychires.2021.02.037. Epub 2021 Feb 17.
Depression is a common comorbid disorder associated with breast cancer, and it can have considerable physical and psychological impacts. Circulating cytokines have been proposed as a potential tool to predict depression in various diseases; however, limited studies have specifically examined it in breast cancer. In this study, we examined and compared the prediction ability of various circulating cytokines for depression in patients with breast cancer. Eighty-three patients with a new diagnosis of breast cancer not receiving chemotherapy were recruited; among them, 15 patients had depression and 68 did not have depression. Depression was evaluated using the Patient Health Questionnaire 9 (PHQ-9). Cytokine levels in the serum were measured using an immunology multiplex assay. Two types of cytokines were assayed: (1) proinflammatory cytokines (interleukin [IL]-1β, IL-2, IL-6, IL-12, IL-17A, interferon [IFN]γ, and tumor necrosis factor [TNF]α) and (2) anti-inflammatory cytokines (IL-4, IL-5, IL-10, and IL-13). Receiver operating characteristic (ROC) analysis was performed to calculate the area under the curves (AUCs), sensitivities, and specificities of circulating cytokines for predicting depression. As a result, IL-2 (AUC = 0.78) and IL-5 (AUC = 0.76) demonstrated good predictability for depression, even after controlling for the covariates (i.e. age, education, stage of cancer, surgery, radiation therapy, and hormone therapy). The optimal cut-off value of IL-2 for predicting depression was 1.06 pg/mL with a sensitivity of 86.7% and a specificity of 52.9%; this cytokine also had the best prediction ability in this study. Owing to the prediction ability and practical feasibility of circulating cytokines, they may be used as a valid laboratory diagnostic tool for depression in breast cancer.
抑郁症是一种与乳腺癌相关的常见共病性疾病，它会产生相当大的生理和心理影响。循环细胞因子已被提议作为预测各种疾病中抑郁症的一种潜在工具；然而，专门针对乳腺癌进行研究的却很有限。在本研究中，我们检测并比较了各种循环细胞因子对乳腺癌患者抑郁症的预测能力。招募了83例新诊断为乳腺癌且未接受化疗的患者；其中，15例患有抑郁症，68例没有抑郁症。使用患者健康问卷9（PHQ - 9）评估抑郁症。采用免疫多重分析法测定血清中的细胞因子水平。检测了两种类型的细胞因子：（1）促炎细胞因子（白细胞介素[IL]-1β、IL - 2、IL - 6、IL - 12、IL - 17A、干扰素[IFN]γ和肿瘤坏死因子[TNF]α）和（2）抗炎细胞因子（IL - 4、IL - 5、IL - 10和IL - 13）。进行受试者操作特征（ROC）分析以计算循环细胞因子预测抑郁症的曲线下面积（AUC）、敏感性和特异性。结果显示，即使在控制协变量（即年龄、教育程度、癌症分期、手术、放疗和激素治疗）后，IL - 2（AUC = 0.78）和IL - 5（AUC = 0.76）对抑郁症仍具有良好的预测能力。预测抑郁症的IL - 2最佳截断值为1.06 pg/mL，敏感性为86.7%，特异性为52.9%；该细胞因子在本研究中也具有最佳预测能力。由于循环细胞因子具有预测能力和实际可行性，它们可能被用作乳腺癌患者抑郁症的一种有效的实验室诊断工具。
