From the Department of Psychological and Brain Sciences (Cuneo, Schrepf, Lutgendorf), University of Iowa, Iowa City, Iowa; Department of Psychology (Szeto, McCabe), University of Miami, Coral Gables, Florida; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology (Thaker), Washington University School of Medicine, St Louis, Missouri; Holden Comprehensive Cancer Center (Goodheart, Lutgendorf) and Division of Gynecologic Oncology, Department of Obstetrics and Gynecology (Goodheart, Lutgendorf), University of Iowa, Iowa City, Iowa; Department of Medicine, Division of Hematology/Oncology and Molecular Biology Institute, David Geffen School of Medicine (Cole), University of California, Los Angeles; Departments of Gynecologic Oncology, Cancer Biology and Center for RNA Interference and Noncoding RNA (Sood), University of Texas MD Anderson Cancer Center, Houston, Texas; and Diabetes Research Institute, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine (Mendez), University of Miami, Coral Gables, Florida.
Psychosom Med. 2021 Jun 1;83(5):417-422. doi: 10.1097/PSY.0000000000000935.
Clinical ovarian cancer research shows relationships between psychosocial factors and disease-promoting aspects of the stress response (e.g., norepinephrine and cortisol). However, little is known about how psychosocial factors might relate to beneficial hormones in the ovarian tumor microenvironment. Here we examine relationships between psychosocial factors and tumor-associated oxytocin, a hormone linked to survival and antitumor processes in ovarian cancer.
Patients with ovarian cancer (n = 96) completed assessments of positive psychosocial factors (social support, positive affect, and purpose in life) and distress (perceived stress and depression) at the time of surgery. Levels of oxytocin and interleukin (IL) 6 in ascites fluid were obtained during surgery and analyzed by enzyme-linked immunosorbent assay. Multiple regression analyses adjusting a priori for patient age and disease stage examined associations between psychosocial factors and ascites oxytocin. IL-6 was used as a covariate in secondary analyses to examine the potentially confounding effects of inflammation in these relationships.
Higher levels of positive affect (β = 0.22, p = .034), purpose in life (β = 0.31, p = .021), and social nurturance (β = 0.24, p = .024) were all related to higher levels of tumor-associated oxytocin at the time of surgery. In contrast, we found no effects for distress or social attachment. Relationships between oxytocin, purpose in life, and social nurturance were independent of IL-6, whereas positive affect was no longer significant with IL-6 in the model.
Tumor-associated oxytocin may be a previously uninvestigated link in the relationship between psychosocial factors and health in ovarian cancer. Future studies should examine causal mechanisms of relationships observed in this study.
临床卵巢癌研究表明,心理社会因素与应激反应促进疾病发展的方面(如去甲肾上腺素和皮质醇)之间存在关系。然而,人们对心理社会因素如何与卵巢肿瘤微环境中的有益激素相关知之甚少。在这里,我们研究了心理社会因素与肿瘤相关的催产素之间的关系,催产素是一种与卵巢癌生存和抗肿瘤过程相关的激素。
在手术时,96 名卵巢癌患者完成了积极的心理社会因素(社会支持、积极情绪和生活目标)和困扰(感知压力和抑郁)的评估。在手术期间获得腹水液中的催产素和白细胞介素(IL)6 水平,并通过酶联免疫吸附测定法进行分析。多元回归分析预先调整了患者年龄和疾病阶段,以检查心理社会因素与腹水催产素之间的关联。在二次分析中,将 IL-6 用作协变量,以检查这些关系中炎症的潜在混杂效应。
较高水平的积极情绪(β=0.22,p=0.034)、生活目标(β=0.31,p=0.021)和社会支持(β=0.24,p=0.024)与手术时肿瘤相关的催产素水平较高相关。相比之下,我们没有发现困扰或社会依恋的影响。催产素、生活目标和社会支持之间的关系独立于 IL-6,而积极情绪在模型中与 IL-6 不再相关。
肿瘤相关的催产素可能是卵巢癌中心理社会因素与健康之间关系中一个以前未被研究的环节。未来的研究应该研究在本研究中观察到的关系的因果机制。