在临床实践中使用情绪功能来检测晚期胸腹部和结直肠癌患者的心理困扰。
Using the emotional functioning in clinical practice to detect psychological distress in patients with advanced thoracic and colorectal cancer.
机构信息
Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain.
Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain.
出版信息
Health Qual Life Outcomes. 2023 Feb 17;21(1):15. doi: 10.1186/s12955-023-02099-w.
PURPOSE
Patients with advanced cancer suffer significant decline of their psychological state. A rapid and reliable evaluation of this state is essential to detect and treat it and improve quality of life. The aim was to probe the usefulness of the emotional function (EF) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EF-EORTC-QLQ-C30) to assess psychological distress in cancer patients.
METHODS
This is a multicenter, prospective, observational study involving 15 Spanish hospitals. Patients diagnosed with unresectable advanced thoracic or colorectal cancer were included. Participants completed the Brief Symptom Inventory 18 (BSI-18), the current the gold standard, and the EF-EORTC-QLQ-C30 to assess their psychological distress prior to initiating systemic antineoplastic treatment. Accuracy, sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) were calculated.
RESULTS
The sample comprised 639 patients: 283 with advanced thoracic cancer and 356 with advanced colorectal cancer. According to the BSI scale, 74% and 66% displayed psychological distress with an EF-EORTC-QLQ-C30 accuracy of 79% and 76% in detecting psychological distress in individuals with advanced thoracic and colorectal cancer, respectively. Sensitivity was 79 and 75% and specificity was 79 and 77% with a PPV of 92 and 86% and a NPV of 56 and 61% (scale cut-off point, 75) for patients with advanced thoracic and colorectal cancer, respectively. The mean AUC for thoracic cancer was 0.84 and, for colorectal cancer, it was 0.85.
CONCLUSION
This study reveals that the EF-EORTC-QLQ-C30 subscale is a simple and effective tool for detecting psychological distress in people with advanced cancer.
目的
晚期癌症患者的心理状态会明显下降。快速可靠地评估这种状态对于发现和治疗疾病、提高生活质量至关重要。本研究旨在探讨欧洲癌症研究与治疗组织生活质量问卷核心 30 量表（EORTC-QLQ-C30）的情绪功能（EF）量表在评估癌症患者心理困扰方面的作用。
方法
这是一项多中心、前瞻性、观察性研究，涉及西班牙的 15 家医院。纳入无法切除的晚期胸部或结直肠癌症患者。患者在开始全身抗肿瘤治疗前，填写简明症状量表 18 项（BSI-18），这是目前的金标准，同时填写 EORTC-QLQ-C30 的 EF 量表，以评估其心理困扰。计算准确性、灵敏度、阳性预测值（PPV）、特异性和阴性预测值（NPV）。
结果
共纳入 639 例患者：283 例为晚期胸部癌症患者，356 例为晚期结直肠癌症患者。根据 BSI 量表，74%和 66%的患者存在心理困扰，EF-EORTC-QLQ-C30 检测晚期胸部和结直肠癌症患者心理困扰的准确性分别为 79%和 76%。灵敏度分别为 79%和 75%，特异性分别为 79%和 77%，PPV 分别为 92%和 86%，NPV 分别为 56%和 61%（截断值为 75）。EF-EORTC-QLQ-C30 量表检测晚期胸部癌症的 AUC 平均值为 0.84，检测晚期结直肠癌症的 AUC 平均值为 0.85。
结论
该研究表明，EORTC-QLQ-C30 的 EF 量表是一种简单有效的工具，可用于检测晚期癌症患者的心理困扰。
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