Relationship between a hopeful attitude and cellular immunity in patients with breast cancer

Objectives

To evaluate the relationship between hopefulness and immune function in patients with breast cancer.

Methods

A total of 196 patients with breast cancer were enrolled. The subjects were divided into two groups using the abbreviated version of the seven-item Beck Hopelessness Scale (BHS-7). Subsets of circulating lymphocytes were assessed using flow cytometry: CD3⁺, CD4⁺, CD8⁺, CD19⁺ and CD56⁺. The Beck Depression Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS) and EORTC QLQ-C30 were administered.

Results

A total of 104 patients (53.6%) showed a hopeful attitude, with a score of 0 on the BHS-7. Scores on the MADRS and BDI were significantly higher in the nonhopeful group, whereas global and total functioning scores on the EORTC QLQ-C-30 were significantly higher in the hopeful group. The hopeful group showed significantly higher CD8⁺ T-cell percentage and counts and significantly lower CD4⁺ T-cell percentage and CD19⁺ B-cell percentage and counts compared with the nonhopeful group. All statistically significant differences between the two groups were maintained after adjusting for age and scores on the BDI and EORTC QLQ-C-30 as covariates, except for CD 19⁺ cell counts.

Conclusion

The results suggest that hopefulness may be associated with immunity in patients with breast cancer, independent of depression and quality of life.