膀胱癌灌注化疗过程中负面情绪对肿瘤负荷及抗肿瘤免疫应答的影响

Effect of negative emotion on tumor load and anti-tumor immune response in bladder cancer infusion chemotherapy

目的:研究膀胱癌灌注化疗过程中负面情绪对肿瘤负荷及抗肿瘤免疫应答的影响。方法:选择2014年5月~2016年12月期间在资阳市第一人民医院接受膀胱灌注化疗的晚期膀胱癌患者,并根据HAMA量表和HAMD量表的评估结果分为不合并负面情绪的对照组、合并焦虑情绪的焦虑组、合并抑郁情绪的抑郁组、合并焦虑和抑郁情绪的焦虑抑郁组。化疗过程中,测定血清中肿瘤标志分子的含量、外周血中免疫细胞的含量以及尿液中凋亡基因的表达量。结果:焦虑组、抑郁组、焦虑抑郁组患者血清中DKK-1、DKK-3、OPN、CYFRA21-1的含量以及外周血中PD-1+CD4^+T细胞、PD-1+CD8^+T细胞、B7-H1+CD11c+DC细胞的含量显著高于对照组,尿液中DAP2IP、Fas、FasL、Caspase-8、PTEN的蛋白表达量显著低于对照组,且焦虑抑郁组患者血清中DKK-1、DKK-3、OPN、CYFRA21-1的含量以及外周血中PD-1+CD4^+T细胞、PD-1+CD8^+T细胞、B7-H1+CD11c+DC细胞的含量显著高于焦虑组、抑郁组,尿液中DAP2IP、Fas、FasL、Caspase-8、PTEN的蛋白表达量显著低于焦虑组、抑郁组。结论:膀胱癌灌注化疗过程中出现的焦虑和抑郁情绪会抑制凋亡基因表达以及抗肿瘤免疫应答并造成癌细胞增殖活力更为旺盛。

Objective:To study the effect of negative emotion on tumor load and anti tumor immune response in bladder cancer infusion chemotherapy.Methods:Patients with advanced bladder cancer who received bladder infusion chemotherapy in the First People’s Hospital of Ziyang between May2014and December2016were selected and divided into the control group without negative emotions,the anxiety group with anxiety,the depression group with depression and the anxiety depression group with both anxiety and depression according to the assessment results of HAMA scale and HAMD scale.The contents of tumor markers in serum,the contents of immune cells in peripheral blood and the expression of apoptosis genes in urine were detected during chemotherapy.Results:DKK1,DKK3,OPN and CYFRA211contents in serum as well as PD1+CD4+T cell,PD1+CD8+T cell and B7H1+CD11c+DC cell contents in peripheral blood of anxiety group,depression group and anxiety depression group were significantly higher than those of control group while DAP2IP,Fas,FasL,Caspase8and PTEN protein expression in urine were significantly lower than those of control group,and DKK1,DKK3,OPN and CYFRA211contents in serum as well as PD1+CD4+T cell,PD1+CD8+T cell and B7H1+CD11c+DC cell contents in peripheral blood of anxiety depression group were significantly higher than those of anxiety group and depression group while DAP2IP,Fas,FasL,Caspase8and PTEN protein expression in urine were significantly lower than those of anxiety group and depression group.Conclusion:The anxiety and depression in bladder cancer infusion chemotherapy can suppress the expression of apoptosis genes and the anti tumor immune response to lead to more vigorous proliferation of cancer cells.