Neises M, Nebe T, Schiller A, Ditz S, Wischnik A, Melchert F
Universitätsfrauenklinik Klinikum Mannheim.
Gynakol Geburtshilfliche Rundsch. 1995;35 Suppl 1:166-71. doi: 10.1159/000272591.
Maladaptive coping of the cancer illness leads to considerable psychosocial burden which can-as a chronic stress factor-impair various immune functions, e.g. cellular immunity.
In a collective of 118 patients suffering from mammary carcinoma and 48 patients suffering from benign mammary tumors Coping was measured with the EORTC-MAC-scale and Quality of life with three questionnaires. Out of the immunologic variables the lymphocyte subpopulations were determined with flow cytometry. Immunglobulines, neopterin, C-reactive protein, and herpes serology were determined using standard methods.
At follow up a slight increase of the mean vales of sum-scores is observed for the adverse coping mechanisms, like helplessness/despair and fear. On the other hand, the values for the coping styles fatalism and denial decrease. Significant correlations are seen between anxious attitude and number of natural killer cells (CD16 and CD56). It must be pointed out that area of social contact show an inverse correlation in patients with mammary cancers: a strong improvement correlates with diminished natural killer cells as well as reduced activated killer cells.
The aim of this study is to determine whether a high risk group can be defined using these parameters and if these parameter can be influenced by psychotherapeutic interventions such as establishing "Coping-support-groups".
癌症患者的适应不良应对方式会导致相当大的心理社会负担,而这种负担作为一种慢性应激因素,可能会损害各种免疫功能,如细胞免疫。
选取118例乳腺癌患者和48例乳腺良性肿瘤患者组成的群体,采用欧洲癌症研究与治疗组织应对量表(EORTC-MAC-scale)测量应对方式,并用三份问卷测量生活质量。免疫变量方面,采用流式细胞术测定淋巴细胞亚群。采用标准方法测定免疫球蛋白、新蝶呤、C反应蛋白和疱疹血清学。
随访时,无助/绝望和恐惧等不良应对机制的总分均值略有增加。另一方面,宿命论和否认等应对方式的值下降。焦虑态度与自然杀伤细胞(CD16和CD56)数量之间存在显著相关性。必须指出的是,乳腺癌患者的社会接触领域呈现负相关:社会接触的显著改善与自然杀伤细胞减少以及活化杀伤细胞减少相关。
本研究的目的是确定是否可以使用这些参数定义一个高危群体,以及这些参数是否可以受到心理治疗干预的影响,如建立“应对支持小组”。