Washington University School of Medicine, St. Louis, MO, United States of America.
Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States of America.
Gynecol Oncol. 2024 Nov;190:96-103. doi: 10.1016/j.ygyno.2024.08.010. Epub 2024 Aug 21.
High-grade (HGOC) and low-grade ovarian carcinoma (LGOC) are distinct malignancies with different biological features, treatment paradigms, and life expectancies. However, differences in quality of life (QOL), sleep, and depressive symptoms have not been examined by grade, and neither have inflammatory profiles associated with these symptoms. We aim to characterize QOL and biomarkers by OC grade.
Participants included patients with HGOC (N = 578) or LGOC (N = 85). Participants completed baseline assessments of psychosocial factors prior to primary surgery or neoadjuvant chemotherapy and contributed saliva for cortisol and blood for interleukin-6 (IL-6) quantification. Samples were collected intraoperatively to quantify tumor cortisol. General linear models were used to examine differences in biological and psychological variables by grade.
At baseline, patients with LGOC reported less depression (p = 0.018) and sleep disturbances (p = 0.014), but no significant difference in depressive mood (p = 0.11) or QOL (p = 0.51) compared to patients with HGOC, adjusting for age and disease stage. There were trends towards lower tumor cortisol levels (p = 0.078) in LGOC compared to HGOC. One-year post-diagnosis, we found a significant improvement in QOL and fatigue, and a decrease in vegetative depression and IL-6 levels irrespective of grade.
We present the first characterization of psychosocial experiences of patients with LGOC. Despite having a better disease prognosis, patients with LGOC were just as likely to have mood disturbances as those with HGOC. There was a trend towards differences in tumor cortisol by grade. Our findings highlight the need to address well-being in patients with both low- and high-grade ovarian malignancies.
高级别（HGOC）和低级别卵巢癌（LGOC）是具有不同生物学特征、治疗模式和预期寿命的截然不同的恶性肿瘤。然而，尚未按等级检查生活质量（QOL）、睡眠和抑郁症状的差异，也没有检查与这些症状相关的炎症特征。我们旨在通过 OC 等级来描述 QOL 和生物标志物。
参与者包括 HGOC（N=578）或 LGOC（N=85）患者。患者在接受原发性手术或新辅助化疗之前完成了心理社会因素的基线评估，并贡献了唾液以测量皮质醇，血液以测量白细胞介素-6（IL-6）的含量。在手术过程中收集样本以量化肿瘤皮质醇。使用一般线性模型按等级检查生物和心理变量的差异。
在基线时，与 HGOC 患者相比，LGOC 患者报告的抑郁（p=0.018）和睡眠障碍（p=0.014）较少，但在抑郁情绪（p=0.11）或 QOL（p=0.51）方面无显著差异，调整了年龄和疾病阶段。与 HGOC 相比，LGOC 的肿瘤皮质醇水平呈下降趋势（p=0.078）。诊断后 1 年，我们发现 QOL 和疲劳均有显著改善，而不论等级如何，植物性抑郁和 IL-6 水平均有所下降。
我们首次描述了 LGOC 患者的心理社会体验。尽管 LGOC 患者的疾病预后较好，但他们出现情绪障碍的可能性与 HGOC 患者一样高。肿瘤皮质醇的等级存在差异的趋势。我们的研究结果强调了需要解决低级别和高级别卵巢恶性肿瘤患者的幸福感问题。
