抑郁 癌因性疲乏对早期肝癌患者术后复发的影响

Effect of depression and fatigue on postoperative disease recurrence in patients undergoing radical operation for early liver cancer

目的探讨抑郁、癌因性疲乏对早期肝癌患者术后复发的影响。方法将122例早期肝癌根治术患者作为研究对象,采用抑郁自评量表与癌症疲乏量表评定患者的抑郁状态和癌因性疲乏状态,比较抑郁自评量表高分组与抑郁自评量表低分组、癌症疲乏量表高分组与癌症疲乏量表低分组患者术后肝衰竭、死亡发生率,分析抑郁、疲乏状态与术后复发的相关性。结果抑郁自评量表高分组肝衰竭、死亡占比分别为10.91%、5.45%,高于抑郁自评量表低分组的2.99%、0但比较差异无统计学意义(P>0.05)。癌症疲乏量表高分组肝衰竭、死亡占比分别为9.62%、3.85%,高于癌症疲乏量表低分组的4.29%、1.43%,但比较差异无统计学意义(P>0.05)。COX风险模型分析显示,肿瘤直径大及抑郁自评量表高分、癌症疲乏量表高分是肝癌患者复发的危险因素,而术后辅助治疗是预防复发的保护因素(P<0.05)。肝癌患者抑郁自评量表评分与癌症疲乏量表评分呈显著正相关(P<0.05)。结论早期肝癌根治术患者术后抑郁、疲乏状态对肝衰竭、死亡的发生未见明显影响,但与肝癌术后复发率密切相关,可增加肝癌的复发风险,是肝癌复发的危险因素。

Objective To explore the effect of depression and fatigue on postoperative recurrence in patients undergoing radical operation for early liver cancer.Methods Depressive and fatigue state were assessed with the Self-rating Depression Scale(SDS)and Cancer Fatigue Scale(CFS)respectively,hepatic failure and mortality were compared between high and low SDS as well as high and low CFS score group,and correlations of postoperative recurrence to depression and fatigue analyzed.Results Liver failure and death proportion were higher in high than in low SDS score group(10.91%and 5.45%vs.2.99%and 0),but differences had no statistical significance(P>0.05).Liver failure and death proportion were higher in high than in low CFS score group(9.62%and 3.85%vs.4.29%and 1.43%),but differences had no statistical significance(P>0.05).COX multivariate risk analysis showed that large diameter tumor,high SDS and CFS score were risk factors for recurrence in liver cancer patients,while postoperative adjuvant therapy was a protective factor to prevent recurrence(P<0.05).There was a significantly positive correlation between the SDS and CFS score in liver cancer patients(P<0.05).Conclusion Post-operative depression and fatigue have no significant effect on the occurrence of liver failure and death in patients undergoing radical surgery for early liver cancer,but are closely related to post-operative relapse rate,could increase the risk of liver cancer relapse,and are risk factors for liver cancer relapse.