Case Western Reserve University School of Nursing, Cleveland, Ohio.
Symptoms Biology Unit, Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland.
Semin Oncol Nurs. 2024 Oct;40(5):151721. doi: 10.1016/j.soncn.2024.151721. Epub 2024 Aug 28.
Cancer-related cognitive impairment (CRCI) is a highly prevalent and debilitating symptom reported by breast cancer survivors (BCS). The etiology of CRCI remains unclear, leading to poor symptom management. Building from prior studies, BCS with the C/C genotype of apolipoprotein E (APOE) rs7412 and the T/T genotype of brain-derived neurotrophic factor (BDNF) rs6265 were hypothesized to experience more severe CRCI. Therefore, we investigated the relationships between the severity of CRCI and polymorphisms of APOE and BDNF among BCS.
This was a subanalysis of data from a larger descriptive, correlational, and cross-sectional study. Subjective and objective CRCI were measured using the Patient-Reported Outcomes Measurement Information System and CANTAB Cambridge Cognitive assessment, respectively. Buccal swab samples were collected to evaluate the single nucleotide polymorphisms. Multivariable generalized linear regression models were used to analyze data.
APOE rs7412 and BDNF rs6265 were significantly associated with lower self-reported cognitive abilities in a total of 353 BCS. Age was positively associated with self-reported cognitive scores, indicating that younger BCS perceived lower cognitive abilities. Individuals carrying genotype of C/T for APOE with the C/C or C/T for BDNF showed positive associations with cognitive abilities.
Younger BCS with the C/C genotype for APOE rs7412 and the T/T genotype for BDNF rs6265 may be at risk for CRCI. Knowledge regarding predictive markers for CRCI symptoms is essential for precision symptom management. Further investigation with a longitudinal and translational design is necessary to explore the etiologies for CRCI.
Integrating genetic phenotyping into routine clinical practice will provide nurses with unique opportunities to understand individual susceptibilities, and how symptoms may trigger other symptoms. Further, findings from these innovative investigations will provide symptom interventionists and implementation scientists with critical data to optimize individualized strategies for symptom prevention, detection, and management.
癌症相关认知障碍（CRCI）是乳腺癌幸存者（BCS）报告的一种高度普遍且使人虚弱的症状。CRCI 的病因仍不清楚，导致症状管理不善。基于先前的研究，载脂蛋白 E（APOE）rs7412 的 C/C 基因型和脑源性神经营养因子（BDNF）rs6265 的 T/T 基因型的 BCS 被假设会经历更严重的 CRCI。因此，我们研究了 BCS 中 CRCI 严重程度与 APOE 和 BDNF 多态性之间的关系。
这是一项对更大的描述性、相关性和横断面研究数据的子分析。使用患者报告的结果测量信息系统和 CANTAB 剑桥认知评估分别测量主观和客观 CRCI。采集口腔拭子样本以评估单核苷酸多态性。使用多变量广义线性回归模型分析数据。
APOE rs7412 和 BDNF rs6265 与 353 名 BCS 的自我报告认知能力显著相关。年龄与自我报告认知评分呈正相关，表明年轻的 BCS 感知到较低的认知能力。APOE 的 C/T 基因型与 C/C 或 C/T 基因型的 BDNF 个体表现出与认知能力的正相关。
APOE rs7412 的 C/C 基因型和 BDNF rs6265 的 T/T 基因型的年轻 BCS 可能有 CRCI 的风险。了解 CRCI 症状的预测标志物对于精确的症状管理至关重要。需要进一步进行纵向和转化设计的研究，以探索 CRCI 的病因。
将基因表型整合到常规临床实践中，将为护士提供独特的机会，了解个体易感性以及症状如何引发其他症状。此外，这些创新性研究的结果将为症状干预者和实施科学家提供关键数据，以优化用于预防、检测和管理症状的个体化策略。
