School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
Department of Medicine - Pulmonary/Critical Care, UW Health, Madison, WI, USA.
J Pediatr Hematol Oncol Nurs. 2024 May-Jun;41(3):157-171. doi: 10.1177/27527530231214544. Epub 2024 Apr 8.
Few studies have examined biomarkers of stress and inflammation as underlying mechanisms of symptoms in adolescents and young adults with cancer. This study determined the feasibility of collecting blood and saliva samples across time, described the range and distribution of biomarkers, and explored the association of biomarkers with symptom adverse events (AEs). This longitudinal, prospective repeated-measures single-site feasibility study recruited = 10 children ( = 12.5 years) receiving treatment for advanced cancer. Symptom AE data and inflammation (cytokines and C-reactive protein) and physiologic response to stress (salivary cortisol and salivary alpha-amylase) biomarker levels were collected at three time points. Descriptive statistics were used to examine feasibility and acceptability and to summarize symptom AE, stress, and inflammatory biomarker data. A linear regression model was used to determine cortisol diurnal slopes. The relationship between symptom and inflammatory biomarker data was explored and Hedges's statistic was used to determine its effect size. Participants provided 83% of saliva samples ( = 199/240) and 185 samples were sufficient to be analyzed. Nurses collected 97% ( = 29/30) of blood samples. Participants reported the saliva collection instructions, kits, and reminders were clear and helpful. Insomnia, pain, fatigue, and anxiety demonstrated the most medium and large negative effects with inflammatory markers. Symptom AEs demonstrated the highest number of medium and large negative effects with interleukin-8 and tumor necrosis factor-alpha (-0.53 to -2.00). The results indicate longitudinal concurrent collection of symptom and biomarker data is feasible and inflammatory and stress biomarkers merit consideration for inclusion in future studies.
很少有研究检查压力和炎症的生物标志物作为癌症青少年和年轻人症状的潜在机制。本研究确定了跨时间采集血液和唾液样本的可行性，描述了生物标志物的范围和分布，并探讨了生物标志物与症状不良事件（AE）的关联。这项纵向、前瞻性重复测量单站点可行性研究招募了 10 名接受晚期癌症治疗的儿童（平均年龄=12.5 岁）。在三个时间点收集症状 AE 数据以及炎症（细胞因子和 C 反应蛋白）和应激生理反应（唾液皮质醇和唾液 α-淀粉酶）生物标志物水平。使用描述性统计来检查可行性和可接受性，并总结症状 AE、应激和炎症生物标志物数据。使用线性回归模型确定皮质醇昼夜斜率。探讨了症状和炎症生物标志物数据之间的关系，并使用 Hedges 的 统计来确定其效应大小。参与者提供了 83%的唾液样本（=199/240），185 个样本足以进行分析。护士收集了 97%的血液样本（=29/30）。参与者报告说，唾液采集说明、试剂盒和提醒非常清晰和有用。失眠、疼痛、疲劳和焦虑与炎症标志物表现出最中等和最大的负相关。症状 AE 与白细胞介素-8 和肿瘤坏死因子-α（-0.53 至-2.00）表现出最高数量的中等和最大负相关。结果表明，纵向同时采集症状和生物标志物数据是可行的，炎症和应激生物标志物值得考虑纳入未来的研究。
