Gan Chen, Yao Senbang, Zhao Jingjing, Shi Huangyuxin, Xu Jian, Zhang Mingjun, Cheng Huaidong
Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Anhui Medical University, Hefei, Anhui, China.
BMC Womens Health. 2025 Mar 25;25(1):140. doi: 10.1186/s12905-025-03674-7.
Breast cancer (BC) survivors frequently endure psychological distress following chemotherapy, with subjective memory decline being a prevalent aspect of chemotherapy-related cognitive impairment (CRCI). This study aimed to assess the influence of psychological distress on subjective memory decline in BC survivors with CRCI and investigate potential underlying mechanisms.
A total of 104 BC survivors who had completed chemotherapy were categorized based on the distress thermometer (DT) score into a no-psychological distress group (NPD group, n = 51) and a psychological distress group (PD group, n = 53). The groups were compared using the Mini-Mental State Examination (MMSE), the Prospective and Retrospective Memory (PM and RM) Questionnaire (PRMQ), cytokine levels (of interleukin-1β [IL-1β], tumor necrosis factor-alpha [TNF-α], and IL-4), and inflammatory markers (neutrophil-to- lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], monocyte count-to-lymphocyte ratio [MLR], granulocyte-to-lymphocyte ratio [GLR], and systemic immune-inflammation index [SII]). Mediation analysis was performed to explore whether cytokine and inflammatory marker levels mediate the effect of psychological distress on subjective memory function complaints.
The NPD group performed significantly better in the PD group both RM (z = -3.370, p = 0.001) and PM (z = -1.967, p = 0.049). The IL-1β levels were substantially higher in the PD group than in the NPD group (z = -2.920, p = 0.004). Similarly, NLR (z = -2.585, p = 0.010), GLR (z = -2.858, p = 0.004), and SII (z = -2.747, p = 0.006) were higher in the PD group. Mediation analysis revealed that IL-1β partially mediated the relationship between DT and RM (β = 0.019, p = 0.007), while SII fully mediated the relationship between DT and PM (β = 0.003, p = 0.017).
BC survivors experiencing psychological distress exhibited worse subjective memory and elevated levels of IL-1β, NLR, GLR, and SII. These findings suggest that inflammation may be a cause of subjective memory function complaints in BC survivors with psychological distress.
乳腺癌（BC）幸存者在化疗后常遭受心理困扰，主观记忆衰退是化疗相关认知障碍（CRCI）的一个普遍表现。本研究旨在评估心理困扰对患有CRCI的BC幸存者主观记忆衰退的影响，并探究潜在的潜在机制。
将104名完成化疗的BC幸存者根据苦恼温度计（DT）评分分为无心理困扰组（NPD组，n = 51）和心理困扰组（PD组，n = 53）。使用简易精神状态检查表（MMSE）、前瞻性和回顾性记忆（PM和RM）问卷（PRMQ）、细胞因子水平（白细胞介素-1β[IL-1β]、肿瘤坏死因子-α[TNF-α]和IL-4）以及炎症标志物（中性粒细胞与淋巴细胞比率[NLR]、血小板与淋巴细胞比率[PLR]、单核细胞计数与淋巴细胞比率[MLR]、粒细胞与淋巴细胞比率[GLR]和全身免疫炎症指数[SII]）对两组进行比较。进行中介分析以探究细胞因子和炎症标志物水平是否介导心理困扰对主观记忆功能主诉的影响。
NPD组在RM（z = -3.370，p = 0.001）和PM（z = -1.967，p = 0.049）方面的表现均显著优于PD组。PD组的IL-1β水平显著高于NPD组（z = -2.920，p = 0.004）。同样地，PD组的NLR（z = -2.585，p = 0.010）、GLR（z = -2.858，p = 0.004）和SII（z = -2.747，p = 0.006）也更高。中介分析显示，IL-1β部分介导了DT与RM之间的关系（β = 0.019，p = 0.007），而SII完全介导了DT与PM之间的关系（β = 0.003，p = 0.017）。
经历心理困扰的BC幸存者表现出更差的主观记忆以及更高水平的IL-1β、NLR、GLR和SII。这些发现表明，炎症可能是患有心理困扰的BC幸存者主观记忆功能主诉的一个原因。
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