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乳腺癌化疗患者的疲劳:一项探索临床、生物学和遗传因素的横断面研究。

Fatigue in breast cancer patients on chemotherapy: a cross-sectional study exploring clinical, biological, and genetic factors.

机构信息

Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.

Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.

出版信息

BMC Cancer. 2022 Jan 3;22(1):16. doi: 10.1186/s12885-021-09072-0.

Abstract

BACKGROUND

Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient's life (physical, psychosocial, professional, and socioeconomic). The aim of this study was to assess the severity of cancer-related fatigue in a group of breast cancer patients undergoing chemotherapy and explore the association between fatigue scores and sociodemographic, clinical, biological, psychiatric, and genetic factors.

METHODS

A cross-sectional pilot study carried out at the oncology outpatient unit of Hôtel-Dieu de France University Hospital recruited 67 breast cancer patients undergoing chemotherapy between November 2017 and June 2019 to evaluate fatigue using the EORTC QLQ-C30 scale (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire). Genotyping for seven gene polymorphisms (COMT, DRD2, OPRM1, CLOCK, PER2, CRY2, ABCB1) was performed using the Lightcycler (Roche).

RESULTS

The prevalence of fatigue was 46.3%. Multivariable analysis taking the fatigue score as the dependent variable showed that a higher number of cycles and a lower hemoglobin level were significantly associated with higher odds of exhibiting fatigue. Moreover, having at least one C allele for DRD2 SNP (vs. TT) was significantly associated with a 4.09 higher odds of expressing fatigue compared to TT patients. Finally, patients with at least one C allele for CLOCK SNP tended to display higher fatigue levels than TT patients.

CONCLUSIONS

Our study showed that anemic breast cancer patients with a high number of chemotherapy cycles and those carrying at least one C allele for DRD2 and CLOCK SNPs are at greater risk of exhibiting fatigue. Since no previous research has reported such genetic results, future studies are necessary to confirm our findings.

摘要

背景

癌症相关疲劳(CRF)是癌症患者在化疗期间最常见和最令人痛苦的抱怨之一,严重影响患者生活的各个方面(身体、心理社会、职业和社会经济)。本研究旨在评估一组接受化疗的乳腺癌患者的癌症相关疲劳严重程度,并探讨疲劳评分与社会人口学、临床、生物学、精神科和遗传因素之间的关联。

方法

在 2017 年 11 月至 2019 年 6 月期间,在法国医院肿瘤门诊单位进行了一项横断面试点研究,招募了 67 名接受化疗的乳腺癌患者,使用 EORTC QLQ-C30 量表(欧洲癌症研究与治疗组织生活质量问卷)评估疲劳。使用 Lightcycler(Roche)对七个基因多态性(COMT、DRD2、OPRM1、CLOCK、PER2、CRY2、ABCB1)进行基因分型。

结果

疲劳的患病率为 46.3%。以疲劳评分作为因变量的多变量分析表明,化疗周期较多和血红蛋白水平较低与疲劳发生的可能性增加显著相关。此外,与 TT 患者相比,DRD2 SNP 至少有一个 C 等位基因(与 TT 相比)与疲劳表达的可能性增加 4.09 倍显著相关。最后,与 TT 患者相比,CLOCK SNP 至少有一个 C 等位基因的患者往往表现出更高的疲劳水平。

结论

我们的研究表明,贫血的乳腺癌患者化疗周期较多,且携带至少一个 DRD2 和 CLOCK SNP 的 C 等位基因的患者发生疲劳的风险更高。由于以前没有研究报道过这种遗传结果,因此需要进一步的研究来证实我们的发现。

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