CALM干预前后伴有CRCI的乳腺癌患者细胞因子水平的变化。
Changes in cytokine levels in breast cancer patients with CRCI before or after CALM intervention.
作者信息
Pang Lulian, Bi Ziran, Jing Yanyan, Yin Xiangxiang, Zhang Xiuqing, Yao Senbang, Zhao Jingjing, Cheng Huaidong
机构信息
Department of Oncology, The Second Affiliated Hospital of Anhui Medical University Hefei 230601, Anhui, China.
出版信息
Am J Cancer Res. 2021 Nov 15;11(11):5415-5427. eCollection 2021.
To investigate the changes in cytokine (interleukin 1 beta (IL-1β), tumor necrosis factor alpha (TNF-α) and interleukin 4 (IL-4)) levels and cognitive function before and after managing cancer and living meaningfully (CALM) intervention, in early-stage breast cancer patients with chemotherapy-related cognitive impairment (CRCI). One hundred and twenty-eight breast cancer patients with CRCI enrolled in this study, there are fifty patients underwent with 6 CALM interventions and seventy-eight patient care as usual (CAU). Cytokine (IL-1β, TNF-α and IL-4) levels in the patients were assessed, and the patients were evaluated with the Mini-Mental State Examination (MMSE), Prospective Memory (PM) and Retrospective Memory (RM), and Quality-of-life (QOL) and Psychological Distress Thermometer (DT) assessments before CALM intervention (BCM), after CALM intervention (ACM) and care of usual (CAU). Measures at these two time points and two groups were compared. There were significant differences in the performance on the RM, PM, MMSE, QOL and DT measures after, compared to before (t=8.126, t=8.007, t=-10.789, t=9.236, t=17.649, respectively; P<0.05), the CALM intervention, compared to CAU (t=-7.408, t=-7.300, t=8.128, t=-8.851, t=-10.572, respectively; P<0.05). In addition, cytokine levels, including IL-1β, TNF-α and IL-4, were significantly different before and after the CALM intervention (t=5.073, t=4.228, t=5.815, respectively; P<0.05) and the two groups (ACM vs CAU) were distinctly different (t=-3.353, t=-2.694, t=-3.268, respectively; P<0.05). furthermore, the cytokine levels (IL-1β, TNF-α and IL-4) have linear correlation with cognitive function before and after CALM intervention (r=-0.343/r=0.538, r=-0.375/r=-0.330, r=-0.310/r=-0.541, respectively; P<0.05). The present results indicated that CALM intervention could alleviate CRCI and that this process is accompanied by changes in IL-1β, TNF-α and IL-4 levels. These results further confirm that cytokines may be involved in CRCI and that CALM may become an efficient method to relieve CRCI-related symptoms in breast cancer patients.
为了研究在有化疗相关认知障碍（CRCI）的早期乳腺癌患者中，进行有意义的癌症管理与生活（CALM）干预前后细胞因子（白细胞介素1β（IL-1β）、肿瘤坏死因子α（TNF-α）和白细胞介素4（IL-4））水平及认知功能的变化。128例患有CRCI的乳腺癌患者纳入本研究，其中50例患者接受了6次CALM干预，78例患者接受常规护理（CAU）。评估患者的细胞因子（IL-1β、TNF-α和IL-4）水平，并在CALM干预前（BCM）、CALM干预后（ACM）和常规护理（CAU）时，用简易精神状态检查表（MMSE）、前瞻性记忆（PM）和回顾性记忆（RM）以及生活质量（QOL）和心理困扰温度计（DT）评估对患者进行评估。比较这两个时间点两组的测量结果。与干预前相比，RM、PM、MMSE、QOL和DT测量结果在干预后有显著差异（分别为t = 8.126、t = 8.007、t = -10.789、t = 9.236、t = 17.649；P < 0.05），CALM干预组与CAU组相比也有显著差异（分别为t = -7.408、t = -7.300、t = 8.128、t = -8.851、t = -10.572；P < 0.05）。此外，包括IL-1β、TNF-α和IL-4在内的细胞因子水平在CALM干预前后有显著差异（分别为t = 5.073、t = 4.228、t = 5.815；P < 0.05），两组（ACM与CAU）之间也有明显差异（分别为t = -3.353、t = -2.694、t = -3.268；P < 0.05）。此外，CALM干预前后细胞因子水平（IL-1β、TNF-α和IL-4）与认知功能存在线性相关性（分别为r = -0.343/r = 0.538，r = -0.375/r = -0.330，r = -0.310/r = -0.541；P < 0.05）。目前的结果表明，CALM干预可以减轻CRCI，并且这个过程伴随着IL-1β、TNF-α和IL-4水平的变化。这些结果进一步证实细胞因子可能参与了CRCI，并且CALM可能成为缓解乳腺癌患者CRCI相关症状的有效方法。
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