Abstract:

Objective　To explore the characteristics of cancer-related fatigue (CRF) in lung cancer survivors and analyze its correlations with anxiety, depression, and stress-related hormones. Methods　A total of 300 lung cancer survivors admitted to Henan Provincial People's Hospital from July 2023 to May 2024 were selected as the study objects. There were 180 males and 120 females, aged from 28 to 72 (50.13±5.66) years, with pathological stage Ⅰ-Ⅳ of 105, 98, 57, and 40, respectively. The Piper's Fatigue Scale (PFS) was used to evaluate the incidence of CRF in lung cancer survivors. According to the PFS score, lung cancer survivors were divided into a CRF group (≥1 point) and a CRF-free group (0 point), and CRF lung cancer survivors were further subdivided into a mild group (1-3 points), a moderate group (4-6 points), and a severe group (≥7 points). The general data (gender, age, education background, marriage, monthly income, chronic diseases, pathological stage, and post-cure time) of 300 lung cancer survivors were analyzed, and the scores of Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) and adrenocorticotropic hormone (ACTH) level of CRF lung cancer survivors with different degrees were compared. Pearson correlation coefficient method was used to analyze the correlations between CRF and HAMA and HAMD scores and ACTH level. t test, ANOVA, and χ² test were used for statistical analysis. Results　A total of 300 lung cancer survivors were included in this study, of whom 268 cases (89.33%) developed CRF, including 80 mild cases (29.86%), 143 moderate cases (53.36%), and 45 severe cases (16.78%). There were statistically significant differences in the education background and post-cure time between the CRF group and the CRF-free group (both P<0.05). The HAMA and HAMD scores and ATCH levels in the severe and moderate groups were higher than those in the mild group, and the above indexes in the severe group were higher than those in the moderate group (all P<0.05). Pearson correlation analysis showed that CRF was positively correlated with HAMA and HAMD scores and ACTH level (r=0.458, 0.403, and 0.411, all P<0.001). Conclusion　Lung cancer survivors' CRF was characterized by a higher risk of CRF with lower educational qualifications and shorter post-cure time, and the degree of CRF was positively correlated with patients' anxiety, depression, and stress-related hormones.

Key words:

Lung cancer, Survivors, Cancer-related fatigue, Anxiety, Depression, Adrenocorticotropic hormone

摘要：

目的　探讨肺癌幸存者癌因性疲乏（CRF）特征，并分析CRF与焦虑、抑郁以及应激相关激素的相关性。方法　选取2023年7月至2024年5月河南省人民医院收治的300例肺癌幸存者作为研究对象。男180例，女120例，年龄28～72（50.13±5.66）岁，病理分期：Ⅰ期105例，Ⅱ期98例，Ⅲ期57例，Ⅳ期40例。采用Piper疲乏量表（PFS）评估肺癌幸存者CRF一般情况。根据PFS评分，将肺癌幸存者分为CRF组（≥1分）和无CRF组（0分），CRF肺癌幸存者进一步细分为轻度组（1～3分）、中度组（4～6分）和重度组（≥7分）。分析300例肺癌幸存者一般资料（性别、年龄、学历、婚姻、月收入、慢性病、病理分期、治愈后时间），比较不同严重程度CRF肺癌幸存者汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）评分及促肾上腺皮质激素（ATCH）水平。采用Pearson相关系数法分析CRF与HAMA、HAMD评分及ACTH水平的相关性。采用t检验、方差分析和χ²检验进行统计学分析。结果　本研究共纳入300例肺癌幸存者，发生CRF 268例（89.33%），其中轻度80例（29.86%）、中度143例（53.36%）、重度45例（16.78%）。CRF组与无CRF组学历、治愈后时间比较，差异均有统计学意义（均P<0.05）。重度组和中度组HAMA、HAMD评分及ATCH水平均高于轻度组，重度组上述指标均高于中度组（均P<0.05）。Pearson相关性分析显示，CRF与HAMA、HAMD评分及ACTH水平呈正相关（r=0.458、0.403、0.411，均P<0.001）。结论　肺癌幸存者CRF发生风险较高，受学历和治愈后时间影响，且CRF与焦虑、抑郁以及应激相关激素密切相关。

关键词:

肺癌, 幸存者, 癌因性疲乏, 焦虑, 抑郁, 促肾上腺皮质激素