我国乳腺癌患者化疗期抑郁症状检出率及其影响因素的系统分析

Detection rate of depression symptoms and its influencing factors in breast cancer patients during chemotherapy in China:a meta-analysis and systematic review

目的系统分析我国乳腺癌患者化疗期抑郁症状检出率及其影响因素。方法以乳腺癌、乳腺肿瘤、化疗、抑郁症状、心理健康等为中文检索词,breast cancer、breast tumor、chemotherapy、depressive symptom、melancholia、Chinese等为英文检索词,检索中国知网、万方、维普、PubMed、Web of Science、Embase数据库,收集自建库至2022年8月我国乳腺癌患者化疗期抑郁症状检出率相关文献。由2名研究者独立筛选文献、提取数据信息并评价偏倚风险后,采用RevMan5.3、Stata14.1对抑郁症状检出率及其影响因素进行系统分析。结果共纳入18篇文献,包含2678例研究对象,我国乳腺癌患者化疗期抑郁症状检出率为51.60%(95%CI:44.10%~55.10%)。年龄(OR=2.55,95%CI:1.26~5.14)、文化程度(OR=2.01,95%CI:1.01~3.98)、婚姻状态(OR=0.50,95%CI:0.29~0.86)、在职状态(OR=3.29,95%CI:1.04~10.46)、临床分期(OR=0.32,95%CI:0.22~0.46)、化疗次数(OR=0.39,95%CI:0.17~0.86)是我国乳腺癌患者化疗期抑郁症状检出率的影响因素(均P<0.05)。结论我国乳腺癌患者抑郁症状检出率较高,年龄<50岁、高中及以下文化程度、非在婚、在职、临床分期3~4期、化疗次数>4次的化疗期乳腺癌患者更易出现抑郁症状。

Objective To systematically evaluate the prevalence of depressive symptoms and its influencing factors in breast cancer patients during chemotherapy in China.Methods The databases such as CNKI,Wanfang Data,VIP,PubMed,Web of Science and Embase were searched with retrieval terms of breast cancer,breast tumor,chemotherapy,depressive symptom,mental health,melancholia,Chinese,etc for the literature related to the prevalence of depressive symptoms in breast cancer patients during chemotherapy in China.Relevant literature from the establishment of the databases to August 2022 were retrieved.Two researchers screened the literature independently,extracted data and evaluated the risk of bias in the included studies,and prevalence of depressive symptoms and its influencing factors in breast cancer patients during chemotherapy in China were systematically evaluated by using RevMan 5.3 and Stata 14.1 software.Results A total of 18 studies were included,including 2678 subjects.Meta-analysis results showed that the prevalence of depressive symptom in breast cancer patients in China was 51.60%(95%CI:44.10%-55.10%).The results of subgroup analysis showed that age(OR=2.55,95%CI:1.26-5.14),educational level(OR=2.01,95%CI:1.01-3.98),marital status(OR=0.50,95%CI:0.29-0.86),occupational status(OR=3.29,95%CI:1.04-10.46),clinical staging(OR=0.32,95%CI:0.22-0.46)and frequency of chemotherapy(OR=0.39,95%CI:0.17-0.86)were the influencing factors of depressive symptoms in breast cancer patients during chemotherapy in China(all P<0.05).Conclusions The prevalence of depressive symptoms in breast cancer patients during chemotherapy in China is high.Breast cancer patients undergoing chemotherapy who are under 50 years old,having a high school education or lower,are not married,currently employed,and in clinical stage 3-4 and receiving more than 4 chemotherapy cycles are more likely to experience depressive symptoms.