de Sousa-Pereira Nathália, Bocchi Mayara, Motoori-Fernandes Caroline Yukari, Banin-Hirata Bruna Karina, Piccoli de Melo Luiz Gustavo, Brajão de Oliveira Karen, Freire Vitiello Glauco Akelinghton, Coral de Oliveira Carlos Eduardo, Zago Campos Clodoaldo, Amarante Marla Karine, Ehara Watanabe Maria Angelica
Laboratory of DNA Polymorphisms and Immunology, Department of Pathological Sciences, Biological Sciences Center, Londrina State University, Paraná, Brazil.
Laboratory of Immunogenetics, Department of Basic Health Sciences, Biological Sciences Center, Maringa State University, Paraná, Brazil.
EXCLI J. 2021 Aug 31;20:1370-1378. doi: 10.17179/excli2021-4005. eCollection 2021.
The clinical course of breast cancer (BC) and survival depend on a wide range of risk factors. From the psychosomatic point of view, BC is one of the most studied type of cancer but there is no evidence available for this relation. Therefore, in the present study we evaluate the impact of chronic life stressors in BC patients. A total of 100 BC patients were invited to participate in an interview, when information about social parameters and emotional changes in the period prior to diagnosis were collected. The emotional changes were evaluated by the Holmes and Rahe's Stress Scale, which analyzes the difficulty required for a person to readjust to society after significant changes in their life. Clinicopathological parameters were obtained from the medical records. For all data, the level of significance adopted was p <0.05. It was observed that 55.2 % of the patients have a medium and 13.8 % were at high risk for disease development related to stressful events in the period prior to the BC diagnosis. The highest stress levels were presented by separated, divorced, or widowed patients compared to married (p <0.01) and single (p = 0.037) patients. The high-risk (HR) group had a lower proportion of positivity for estrogen receptor when compared to the low (LR) and moderate risk (MR) groups (p= 0.001). In addition, a binary logistic regression analysis was performed, and we found that the relationship between the estrogen receptor and the HR of chronic stress was independently associated with the histological type of BC and lymph nodes involvement. The relationship of stressful life experiences and BC is not well established, so our study collaborates with the literature to demonstrate the importance of stress as a factor associated with the development of BC.
乳腺癌(BC)的临床病程和生存率取决于多种风险因素。从心身角度来看,BC是研究最多的癌症类型之一,但尚无证据证明这种关系。因此,在本研究中,我们评估了慢性生活应激源对BC患者的影响。共有100名BC患者被邀请参加访谈,收集了有关诊断前时期的社会参数和情绪变化的信息。情绪变化通过霍姆斯和拉赫压力量表进行评估,该量表分析了一个人在生活发生重大变化后重新适应社会所需的难度。临床病理参数从医疗记录中获取。对于所有数据,采用的显著性水平为p<0.05。观察到55.2%的患者处于中度风险,13.8%的患者在BC诊断前时期因应激事件而处于疾病发展的高风险。与已婚(p<0.01)和单身(p=0.037)患者相比,分居、离婚或丧偶患者的压力水平最高。与低风险(LR)和中度风险(MR)组相比,高风险(HR)组雌激素受体阳性比例较低(p=0.001)。此外,进行了二元逻辑回归分析,我们发现雌激素受体与慢性应激的HR之间的关系与BC的组织学类型和淋巴结受累独立相关。应激性生活经历与BC之间的关系尚未明确,因此我们的研究与文献合作,以证明应激作为与BC发展相关因素的重要性。