HCC患者围介入期抑郁情况调查及其与血清脑源性神经营养因子的相关性  

Survey of depression in patients with hepatocellular carcinoma during perioperative period of interventional treatment and its correlation with serum BDNF concentration

作　　者：蒋逢辰 周水平 陈世园 沈家宝 王庆华 戚龙菊 JIANG Fengchen;ZHOU Shuiping;CHEN Shiyuan;SHEN Jiabao;WANG Qinghua;QI Longju(School of Nursing,Medical School of Nantong University,Nantong,Jiangsu Province 226001,China)

机构地区：[1]南通大学医学院护理学院,江苏南通226001 [2]南通大学杏林学院 [3]南通大学实验动物中心 [4]南通市第三人民医院(南通大学附属南通第三医院)介入血管科

出　　处：《介入放射学杂志》2023年第11期1106-1109,共4页Journal of Interventional Radiology

基　　金：南通市科技局资助项目(MS12021039,MS12018020);国家级大学生创新创业训练计划(202110304036Z);南通大学博士科研启动基金(135420505015)。

摘　　要：目的 了解接受肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)的肝细胞癌(hepatocellular carcinoma,HCC)患者抑郁发生情况及其与血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)表达的相关性。方法 选择2018年1月至2019年12月南通市第三人民医院行TACE治疗的HCC患者303例,采用医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)对HCC患者进行抑郁情况调查,收集患者TACE治疗前1 d血清标本,采用ELISA法检测患者血清BDNF浓度,比较抑郁者与非抑郁者血清BDNF浓度。利用受试者工作特性曲线下面积(AUC)评估血清BDNF浓度对抑郁的诊断价值。对抑郁者随访3个月,再次测定其抑郁评分及血清BDNF浓度且进行相关性分析。结果 303例HCC患者中,抑郁患者183例(60.40%),焦虑患者159例(52.48%)。120例非抑郁患者血清BDNF浓度为(30 040.21±8 481.55) pg/mL,183例抑郁患者血清BDNF浓度为(23 555.55±6 921.10) pg/mL,差异有统计学意义(t=7.286,P<0.05);BDNF的AUC为0.749(95%CI:0.687~0.811,P<0.01),约登指数为0.497,截断值为30 901.62 pg/mL;BDNF浓度越高,HADS-D评分越低,反之BDNF浓度越低,HADS-D评分越高,两者呈线性趋势关系,变化方向相反,Pearson相关系数为-0.730,相关系数的双侧检验P<0.05。结论 HCC患者围介入期抑郁发生率为60.40%,HCC抑郁患者的BDNF低于非抑郁患者,且BDNF表达量与抑郁评分呈负相关。Objective To investigate the occurrence of depression in patients with hepatocellular carcinoma(HCC) receiving transcatheter arterial chemoembolization(TACE) therapy,and to analyze the correlation between the depression and the expression of serum brain-derived neurotrophic factor(BDNF).Methods A total of 303 patients with HCC,who were treated with TACE at the Nantong Third People's Hospital of China between January 2018 and December 2019,were enrolled in this study.By using the hospital anxiety and depression scale(HADS) a survey about the depression status in HCC patients was conducted.The serum sampling for patients was performed one day before TACE treatment.The patients' BDNF concentrations were measured by ELISA.The serum BDNF concentrations were compared between the depression patients and the non-depression patients.The area under receiver operating characteristic(ROC) curve(AUC) was used to assess the diagnostic value of serum BDNF concentrations for depression.The depression patients were followed up for 3 months,the depression score and serum BDNF concentration were determined again and the correlation between the two was analyzed.Results Among the 303 HCC patients,there were 183(60.40%)depression patients and 159(52.48%) anxiety patients.The serum BDNF concentration in 120 non-depression patients was(30 040.21±8 481.55) pg/mL,which in the 183 depression patients was(23 555.55±6 921.10) pg/mL,the difference between the two groups was statistically significant(t=7.286,P<0.05).The AUC of BDNF was 0.749 2(95%CI:0.6872-0.8112,P<0.001),the Youden index was 0.497,and the cutoff value was 30 901.62 pg/ml.The higher BDNF concentration was,the lower HADS-D score would be,and vice versa.The above two indexes showed a linear trend relationship with a opposite changing direction.The Pearson correlation coefficient was-0.730,and the two-sided test of the correlation coefficient was P <0.05.Conclusion The incidence of depression in HCC patients during the perioperative period of interventional treatment is 60.40%.

关 键 词：肝细胞癌 肝动脉栓塞化疗 抑郁 脑源性神经营养因子 

分 类 号：R735.7[医药卫生—肿瘤]