中国科学院心理健康重点实验室知识库

目的 探讨河南林州食管、贲门癌前病变患者心理状况及相关因素.方法 以2015年7月至2016年1月在林州肿瘤医院参加上消化道早诊早治内镜筛查项目的40~69岁人群为研究对象.以118例低级别上皮内瘤变或高级别上皮内瘤变患者为癌前病变组,210名病理级别正常的对象为对照组.采用社会支持评价量表(SSRS)、焦虑自评量表(SAS,分数≥50分为存在焦虑)及抑郁自评量表(SDS,分数≥53分为存在抑郁)调查研究对象心理状况,计算其焦虑、抑郁和社会支持得分.比较两组对象上述得分差异,采用多因素logistic回归模型分析影响研究对象癌前病变和心理状况的相关因素.结果 病例组中食管癌前病变72例,贲门癌前病变40例,食管贲门双源性癌前病变为6例.病例组年龄为(57.17±7.71)岁,对照组年龄为(53.12±7.99)岁,两组年龄差异有统计学意义(P〈0.001).焦虑、抑郁量表结果显示,癌前病变组SAS和SDS得分分别为37.18±10.01和40.44±8.73,对照组得分分别为34.02±6.63和38.49±8.73,两组焦虑、抑郁症状差异均有统计学意义(P值分别为0.002和0032);对照组对象社会支持总分、主观支持得分、客观支持得分分别为38.26±5.26、24.08±3.83和7.50±1.89,均高于癌前病变组(36.80±6.18、23.01±3.93和6.93±1.57),差异均有统计学意义(P值分别为0.024、0.016、0.004).此外,主观和客观社会支持得分较低、存在焦虑症状者发生癌前病变的可能性较高,OR值分别为0.81、0.72和1.05,P值分别为0.028、0.005和0.009.结论 社会支持、焦虑、抑郁与食管、贲门癌前病变的发生可能有一定关联.

Objective To explore the psychological status and related factors in patients with precancerous of esophageal and gastric cardia in Linzhou of Henan. Methods Clinical psycho-rating scale of Social Support Rating Scale (SSRS), Self-Rating Anxiety Scale (SAS,score ≥50 points with symptoms of anxiety) and Self-Rating Depression Scale (SDS, score ≥53 points with the symptoms of depression) were applied to survey life events and psychological status of subjects who aged 40-69 years old and participated in"The Early diagnosis and Early Treatment"program in Linzhou cancer hospital from July 2015 to Jan 2016. Patients with lower intraepithelial neoplasia or high-grade intraepithelial neoplasia were selected as precancerous lesions (n=118), and patients with normal grade were selected as healthy controls (n=210). Compare the differences of the scores between the two groups, and the logistic regression model was used to analyze the related factors of precancerous lesions and psychological status of the study subjects. Results Precancerous lesions included esophageal (72 cases), gastric cardia (40 cases), esophageal and cardia dual source (6 cases); Precancerous lesions and healthy controls aged (57.17±7.71) and (53.12±7.99) years old,the difference was statistically significant (P〈0.001). The anxiety and depression scale showed that the scores of SAS and SDS scores in the precancerous lesions were (37.18±10.01), (40.44±8.37) points, and (34.02 ± 6.63), (38.49 ± 8.73) points in control group, the difference was statistically significant (P=0.002, 0.032). While the social support total score (38.26±5.26), and subjective support score (24.08±3.83) and objective support score (7.50±1.89) in control group were all higher than those of precancerous group (36.80± 6.18, 23.01±3.93, 6.93±1.57), and the difference were statistically significant (P=0.024, 0.016, 0.004). In addition, the Logistic analysis showed that subjects with low objective social support, subjective social support and anxiety symptoms were more likely to develop precancerous lesions, and the OR were 0.81, 0.72 and 1.05, respectively (P=0.028, 0.005, 0.009). Conclusion Social support, anxiety and depression status may be related to the occurrence and development of esophageal and gastric cardia precancerous lesions.

国家公益性行业科研专项(201502001);国家自然科学基金(81573224)