摘要
Objective:To study the effect of anxiety after chemotherapy on antitumor immune response and tumor load in patients with advanced gastric cancer.Methods:Patients with gastric cancer who received SOX chemotherapy in the First People's Hospital of Ziyang Sichuan Province between May 2012 and October 2015 were selected and divided into no anxiety group with HAMA score≤7 points, mild anxiety group with HAMA score 7-14 points, moderate anxiety group with HAMA score 14-21 points and severe anxiety group with HAMA score>21 points according to the HAMA score after four courses of chemotherapy. Cytokine and tumor marker levels in serum, immune cell levels in peripheral blood as well as proliferation gene expression in lesions were determined.Results: Peripheral blood Th1 levels as well as serum IL-2 and IFN-γ levels of mild anxiety group, moderate anxiety group and severe anxiety group were significantly lower than those of no anxiety group while peripheral blood Th2, Th17 and Treg levels as well as serum IL-4, IL-5, IL-17, IL-10, CEA, CA19-9, TK-1 and VEGF levels were significantly higher than those of no anxiety group, and EPHA2, c-myc and PCNA mRNA expression in tumor lesions were significantly higher than those of no anxiety group;the severer the anxiety, the lower the peripheral blood Th1 levels as well as serum IL-2 and IFN-γ levels, the higher the peripheral blood Th2, Th17 and Treg levels as well as serum IL-4, IL-5, IL-17, IL-10, CEA, CA19-9, TK-1 and VEGF levels, and the higher the EPHA2, c-myc and PCNA mRNA expression in tumor lesions.Conclusion:The aggravated anxiety in patients with advanced gastric cancer after chemotherapy will inhibit the antitumor immune response and increase the tumor load.
