口腔鳞癌患焦虑和抑郁调查及血液检查分析

Investigation of anxiety and depression in patients with oral squamous cellcarcinoma and analysis of blood examination

目的 通过调查口腔鳞状细胞癌患者焦虑和抑郁现况,并研究病情与患者血液检查项目的相关性,寻找对口腔鳞癌患者抑郁和焦虑具有诊断价值的潜在生物标志物,以早期识别和治疗,提高临床疗效和患者生活质量。方法 2021年4月至2022年2月在不影响正常治疗程序前提下采用便利抽样法选取重庆医科大学附属口腔医院收治的住院口腔鳞癌患者60例,发放一般资料调查表、焦虑自评量表(SAS)、贝克抑郁自评量表(BDI),对患者进行横断面调查。采用SPSS24.0统计软件进行分析,正态性检验采用Kolmogorov-Smirnov和Shapiro-Wilk检验。采用均数、标准差、百分比对患者的一般状况、心理状态进行描述性分析;采用Person相关对患者SAS、BDI评分与血液检查进行相关性分析;采用独立样本t检验进行组间比较。结果 60例患者平均SAS评分为(29.46±4.45)分,均无明显焦虑症状,阳性率为0;平均BDI评分为(15.22±3.33)分。55.00%(33/60)的患者伴有抑郁症状(抑郁症组),其中轻度抑郁26例[43.33%(26/60)],中度抑郁症状7例[11.67%(7/60)];男15例[40.54%(15/37)],女18例[78.26%(18/23)];发病部位为舌的患者27例,其中有12例患者出现抑郁症状。红细胞、血红蛋白、血细胞比容、凝血酶原时间、国际标准化比值与BDI评分呈明显负相关(r=-0.486、-0.343、-0.381、-0.303、-0.313,P<0.001、0.007、0.003、0.020、0.016),平均红细胞比容、平均红细胞血红蛋白、红细胞标准差与BDI评分呈明显正相关(r=0.411、0.403、0.452,P=0.001、0.001、<0.001)。抑郁症组患者单核细胞绝对值、红细胞、活化部分凝血活酶时间、凝血酶原时间、国际标准化比值与正常组比较,差异均有统计学意义(P<0.05)。结论 口腔癌患者SAS评分与血液检查各项数据均无关,BDI评分与血液检查数据中与凝血相关的各项目具有相关性,抑郁患者各项目与正常者具有差异性。

Objective To investigate the current status of anxiety and depression in patients with oral squamous cell carcinoma,and to study the correlation between the condition and blood test items of patients in order to find potential biomarkers that with diagnostic value for depression and anxiety in patients with oral squamous cell carcinoma,so as to identify and treat the patients early and improve clinical treatment effectiveness and quality of life.Methods From April 2021 to February 2022,without affecting their normal treatment procedures,patients with oral squamous cell carcinoma who were hospitalized from the Stomatological Hospital of Chongqing Medical University were selected by the convenient sampling method.A cross-sectional survey was conducted on the patients using a general information questionnaire,the Self Rating Anxiety Scale(SAS),and the Beck Depression Inventory(BDI).SPSS 24.0 software was used for statistical analysis,and Kolmogorov-Smirnov and Shapiro-Wilk tests were used for normality testing.Descriptive analysis was conducted on the general and psychological status of patients using mean,standard deviation,and percentage.The correlation analysis of SAS,BDI scores and blood tests was performed using Person correlation.Independent sample t-tests were used for group comparison.Results The average SAS score of the 60 patients was(29.46±4.45),with no significant anxiety symptoms,and the positive rate was 0.The average BDI score was(15.22±3.33),and 55%(33/60)patients had depressive symptoms(the depression group),including 26 patients with mild depressive symptoms[43.33%(26/60)],seven patients with moderate depressive symptoms[11.67%(7/60)],15 males[40.54%(15/37)],and 18 females[78.26%(18/23)].Of the 27 patients with the tongue as the site of onset,12 had depressive symptoms.Erythrocyte,hemoglobin,hematocrit,prothrombin time and international standardized ratio were significantly negatively correlated with BDI score(r=-0.486,-0.343,-0.381,-0.303,-0.313,P<0.001,0.007,0.003,0.020,0.016).Mean erythrocyte specific volume,mean erythrocyte hemoglobin and erythrocyte standard deviation were significantly positively correlated with BDI score(r=0.411,0.403,0.452,P=0.001,0.001,<0.001).The absolute value of monocyte,erythrocyte,activated partial thromboplastin time,prothrombin time and international standardized ratio in the depression group were significantly different from those in the normal group(P<0.05).Conclusion There was no correlation between the SAS score and blood test data in patients with oral cancer.There was a correlation between the BDI score of oral cancer patients and various items related to blood coagulation in the humoral examination data,and there were differences between depressed patients and normal patients.