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晚期肺癌患者癌症相关性疲乏的发生及其与血清炎性因子的关系

Cancer-related Fatigue in Advanced Lung Cancer Patients and Its Relationship with Inflammatory Cytokine in Serum

  • 摘要: 目的 本研究拟评估晚期肺癌患者癌症相关性疲乏(cancer-related fatigue, CRF)发生情况,测定血清中CRP、CORT、IL-6的水平,探究该指标与CRF之间的相关性。方法 应用FACIT-F量表对51例晚期肺癌患者进行CRF评估。采用免疫比浊法测定血清CRP水平,免疫微粒电发光法测定CORT水平,采用双抗体夹心酶联免疫吸附ELISA法测定IL-6水平。采用Spearman相关分析方法分析量表得分与血清炎性因子水平的相关程度。应用Logistic回归分析进行危险因素分析。结果 27例患者附加关注子量表得分≤34分,CRF发生率为52.9%。存在疼痛的患者身体状况及附加关注得分低于无疼痛患者(P=0.009, P=0.018)。睡眠障碍显著影响身体状况、附加关注及总分值得分,存在睡眠障碍者三项得分均明显低于无睡眠障碍患者(P<0.01)。血清CRP水平与身体状况、功能状况、附加关注、总得分呈负相关(P值分别为0.004、0.027、0.007、0.013)。IL-6水平与身体状况、附加关注及总分值呈负相关(P值分别为0.044、0.029、0.023)。CORT水平与量表得分无显著相关。睡眠障碍和疼痛是CRF的独立危险因素,OR值分别为6.167、7.405(P=0.010, P=0.005)。结论 血清IL-6、CRP水平高低与患者疲乏程度显著相关,血清IL-6、CRP水平越高与患者疲乏程度相关性越显著,IL-6、CRP可作为临床监测疲乏程度的指标。合并疼痛、睡眠障碍的患者更容易发生疲乏、疲乏程度更严重。

     

    Abstract: Objective To evaluate the incidence of cancer-related fatigue(CRF) in patients with advanced lung cancer, and to measure the levels of CRP, IL-6 and CORT to explore the correlation between the indexes and CRF. Methods We used FACIT-F scale to assess the CRF in 51 patients with advanced lung cancer. The serum level of CRP was measured by immunoturbidimetry, the level of CORT was determined by immune particle electro chemiluminescence method, and the IL-6 level was tested by double antibody sandwich enzyme linked immunosorbent assay(ELISA). Spearman correlation analysis was applied to analyze the correlation of score of FACIT-F scale with the level of markers in the serum, and Logistic regression was used to analyze the risk factors. Results The additional concerns subscale score of 27 patients was ≤34 and the incidence of CRF was 52.9%. Physical condition and additional concerns subscale scores of patients with pain were lower than those without pain(P=0.009, P=0.018). Sleep disorders had significant impact on physical condition, additional concerns and total score. Scores of patients with sleep disorders were significantly lower than those without sleep disorders (P<0.01). CRP levels in serum were negatively correlated with physical condition, functional condition, additional attention and total score(P=0.004, 0.027, 0.007, 0.013). IL-6 level was negatively correlated with physical condition, additional attention and total score(P=0.044, 0.029, 0.023). CORT level had no correlation with scale scores. Sleep disorders and pain were independent risk factors for CRF, and OR values were 6.167 and 7.405 (P=0.010, 0.005). Conclusion The levels of IL-6, CRP in serum are significantly associated with the degree of fatigue; the higher levels of IL-6 and CRP are, the more significant correlation is. CRP and IL-6 could be used as clinical monitoring indexes of fatigue. Patients with pain and sleep disorder are more prone to fatigue, and the fatigue degree is more serious.

     

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