Hoogland Aasha I, Small Brent J, Oswald Laura B, Bryant Crystal, Rodriguez Yvelise, Gonzalez Brian D, Li Xiaoyin, Janelsins Michelle C, Bulls Hailey W, James Brian W, Arboleda Bianca, Colon-Echevarria Claudia, Townsend Mary K, Tworoger Shelley S, Rodriguez Paulo C, Bower Julienne E, Apte Sachin M, Wenham Robert M, Jim Heather S L
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA.
School of Aging Studies, University of South Florida, Tampa, FL 33612, USA.
Cancers (Basel). 2023 Jun 29;15(13):3407. doi: 10.3390/cancers15133407.
Previous research suggests that inflammation triggers cancer-treatment-related symptoms (i.e., fatigue, depression, and disruptions in sleep and physical activity), but evidence is mixed. This study examined relationships between inflammatory biomarkers and symptoms in patients with gynecologic cancer compared to age-matched women with no cancer history (i.e., controls). Patients ( = 121) completed assessments before chemotherapy cycles 1, 3, and 6, and 6 and 12 months later. Controls ( = 105) completed assessments at similar timepoints. Changes in inflammation and symptomatology were evaluated using random-effects mixed models, and cross-sectional differences between patients and controls in inflammatory biomarkers and symptoms were evaluated using least squares means. Associations among inflammatory biomarkers and symptoms were evaluated using random-effects fluctuation mixed models. The results indicated that compared to controls, patients typically have higher inflammatory biomarkers (i.e., TNF-alpha, TNFR1, TNFR2, CRP, IL-1ra) and worse fatigue, depression, and sleep (s < 0.05). Patients reported lower levels of baseline physical activity ( = 0.02) that became more similar to controls over time. Significant associations were observed between CRP, depression, and physical activity (s < 0.05), but not between inflammation and other symptoms. The results suggest that inflammation may not play a significant role in fatigue or sleep disturbance among gynecologic cancer patients but may contribute to depression and physical inactivity.
先前的研究表明，炎症会引发与癌症治疗相关的症状（即疲劳、抑郁以及睡眠和身体活动的紊乱），但证据并不一致。本研究调查了妇科癌症患者与无癌症病史的年龄匹配女性（即对照组）相比，炎症生物标志物与症状之间的关系。患者（n = 121）在化疗第1、3和6周期之前以及之后6个月和12个月完成评估。对照组（n = 105）在类似的时间点完成评估。使用随机效应混合模型评估炎症和症状学的变化，使用最小二乘均值评估患者与对照组在炎症生物标志物和症状方面的横断面差异。使用随机效应波动混合模型评估炎症生物标志物与症状之间的关联。结果表明，与对照组相比，患者通常具有更高的炎症生物标志物（即肿瘤坏死因子-α、肿瘤坏死因子受体1、肿瘤坏死因子受体2、C反应蛋白、白细胞介素-1受体拮抗剂）以及更严重的疲劳、抑郁和睡眠问题（P < 0.05）。患者报告的基线身体活动水平较低（P = 0.02），随着时间推移与对照组变得更为相似。观察到C反应蛋白、抑郁和身体活动之间存在显著关联（P < 0.05），但炎症与其他症状之间无显著关联。结果表明，炎症可能在妇科癌症患者的疲劳或睡眠障碍中不起重要作用，但可能导致抑郁和身体活动不足。
