抑郁发生与肺癌患者生存结局关系的研究进展

近年来肺癌发病率和病死率居高不下，与肺癌相关的心理健康问题如抑郁也开始得到关注。越来越多的 研究对抑郁发生与肺癌患者生存时间或病死率的关系提出了假说，并在基础研究、前瞻性队列研究和干预研究等方 面取得了一定进展。基础研究发现：癌症可通过介导炎症因子的产生导致抑郁情绪的发生；皮质醇和肿瘤表皮生长 因子受体基因型可从一定角度解释肺癌患者的高病死率和患抑郁的风险。在前瞻性队列研究中对于抑郁是肺癌患者 生存期的重要预测因子存在争议，需要进一步明确。在干预研究方面，虽然有研究证实抗抑郁药物在抗肿瘤氧化治 疗方面的潜力，但尚未有充足证据证明心理干预和药物干预对改善肺癌生存结局的有效性。今后有必要进一步阐明 抗抑郁药和心理干预对提高该群体生存期的机制。

Research progress in the relationship between depression and survival outcome in patients with lung cancer

In recent years, with the high incidence of lung cancer and mortality, the disease-relevant mental health problems such as depression began to attract attention. A growing number of studies have also begun to hypothesize and confi rm the relationship between depression and survival or mortality in patients with lung cancer, and have made some progress in basic research, prospectivecohort research and intervention research. In basic research, cancer can cause depression due to mediating the production of inflammatory factors, and the genotype of tumor epidermis growth factor receptor (EGFR) can explain the high mortality and risk of depression in patients with lung cancer from a certain point of view. Different studies in prospective cohort studies argue that depression is an important predictor of survival in patients with lung cancer and need to be further studied. In the aspect of intervention research, although some studies have confirmed the potential of antidepressants in anti-tumor oxidative therapy, there is no enough evidence in psychological intervention and drug intervention to prove their effectiveness in improving the survival outcome of lung cancer. In the future, it is necessary to further explore the possible mechanisms for antidepressants and psychological intervention to improve the survival time of the patients.