Chen Po See, Shen Yang-Chen, Lin Cheng-Feng, Liu Ping-Yen, Lin Peng-Chan, Su Pei-Fang, Yen Chia-Jui, Shan Yan-Shen
From the Institute of Behavioral Medicine, College of Medicine (Chen, Shen), Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine (Chen), Department of Physical Therapy, College of Medicine (Lin), Division of Cardiology, Internal Medicine, National Cheng Kung University Hospital, College of Medicine (Liu), Institute of Clinical Medicine, College of Medicine (Liu, Shan), and Department of Oncology, National Cheng Kung University Hospital, College of Medicine (Lin, Yen), Department of Statistics, College of Management (Su), and Department of Surgery, National Cheng Kung University Hospital, College of Medicine (Shan), National Cheng Kung University, Tainan, Taiwan.
Biopsychosoc Sci Med. 2025;87(2):146-152. doi: 10.1097/PSY.0000000000001368.
This study explores the potential connections between clinical depression, inflammation, and cancer progression in pancreatic cancer patients.
Conducted from May 2021 to May 2023 at the National Cheng Kung University Hospital Clinical Data Warehouse, this prospective study involved 279 pancreatic cancer patients. The nine-item self-reported Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. The study focused on the correlation between clinically significant depression (PHQ-9 scores >10), levels of inflammatory factors, and patient survival rates.
At the time of diagnosis, 34.0% of the patients exhibited clinically significant depression. Analysis using Fixed Effects in Generalized Linear Mixed Models (GLMM) revealed a notable link between log-transformed C-reactive protein (ln CRP) levels with occurrence of depression (odds ratio [OR] = 1.274, p = .010). Furthermore, a univariate Cox proportional hazard model with time-varying covariates indicated a correlation between clinically significant depression and decreased overall survival (hazard ratio [HR] = 6.245, p < .001). A multivariate Cox model also showed significant associations of both ln CRP levels (HR = 1.966, p = .030) and clinically significant depression (HR = 3.611, p = .028) with survival outcomes.
The findings highlight a complex interplay between inflammation, depression, and survival in pancreatic cancer patients. However, the study is limited by the lack of control over all potential confounders, such as chronic conditions, which could independently influence both depression and inflammatory biomarkers.
本研究探讨胰腺癌患者临床抑郁症、炎症与癌症进展之间的潜在联系。
本前瞻性研究于2021年5月至2023年5月在国立成功大学医院临床数据仓库进行，纳入了279例胰腺癌患者。采用九项自我报告的患者健康问卷（PHQ-9）评估抑郁症状。该研究重点关注临床显著抑郁症（PHQ-9评分>10）、炎症因子水平与患者生存率之间的相关性。
在诊断时，34.0%的患者表现出临床显著抑郁症。使用广义线性混合模型（GLMM）中的固定效应进行分析发现，对数转换后的C反应蛋白（ln CRP）水平与抑郁症的发生之间存在显著联系（优势比[OR]=1.274，p=0.010）。此外，一个具有随时间变化协变量的单变量Cox比例风险模型表明，临床显著抑郁症与总生存率降低之间存在相关性（风险比[HR]=6.245，p<0.001）。多变量Cox模型也显示ln CRP水平（HR=1.966，p=0.030）和临床显著抑郁症（HR=3.611，p=0.028）与生存结果均存在显著关联。
研究结果突出了胰腺癌患者炎症、抑郁症和生存之间的复杂相互作用。然而，该研究受到缺乏对所有潜在混杂因素控制的限制，如慢性病，这些因素可能独立影响抑郁症和炎症生物标志物。
