Correlation Between 5-HT/Pro-GRP And Anxiety/Depression In Patients With Small Cell Lung Cancer

Background and objective: Lung cancer is the most common malignant tumor in China,in which small cell lung cancer(SCLC)accounts for 15%-20% of all lung cancer.Chemotherapy plays an important role in the treatment of small cell lung cancer,but anxiety and depression often occur in patients with chemotherapy,which seriously affect their quality of life,reduce their compliance,and then affect the efficacy of treatment.In recent years,the anxiety and depression of advanced cancer patients with chemotherapy have attracted more and more attention of oncologist,but the mechanism of its occurrence is still less studied.The anxiety and depression of chemotherapy patients seriously affect their own function and hinder their improvement.Compared with the normal people,tumor patients are more likely to produce anxiety and depression.Related studies have shown that abnormal secretion of monoamine neurotransmitters such as 5-hydroxy tryptamine(5-HT)can lead to anxiety and depression.In addition,gastrin-releasing peptide(GRP)can cause anxiety and depression through interaction with 5-HT and adrenocortical hormone-releasing hormone.It can also affect anxiety and depression of tumor patients through gastrin-releasing peptide/gastrin-releasing peptide receptor system.In this study,Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)were used toevaluate the anxiety and depression status of patients with small cell lung cancer before and after chemotherapy.The levels of serum 5-HT and Gastrin-Releasing Peptide Precursor(Pro-GRP)were measured before and after chemotherapy in patients with small cell lung cancer,And then analyze the relationship between 5-HT and Pro-GRP,anxiety and depression,then explore the mechanism of their occurrence.In order to provide the necessary theoretical support for the small cell lung cancer chemotherapy patients to improve the mood of drug treatment and psychological intervention.Methods: This study included 22 patients with small cell lung cancer who received initial chemotherapy in our hospital between May 2018 to January 2019.SDS and SAS were used to evaluate anxiety and depression in patients with small cell lung cancer before and after chemotherapy.Serum 5-HT and Pro-GRP were measured by enzyme-linked immunosorbent assay(ELISA)in patients with small cell lung cancer before and after chemotherapy.SAS/SDS score and blood sampling test were performed on the first day of admission.SAS/SDS score and blood sampling test were performed48 hours after chemotherapy.SPSS 17.0 statistical software was used to analyze the data of serum 5-HT/Pro-GRP and anxiety/depression before and after chemotherapy.5-HT/Pro-GRP and SAS/SDS scores were expressed by mean±standard deviation(x±s).The content of 5-HT/Pro-GRP before and after chemotherapy was analyzed by paired t-test with the score of SAS/SDS before and after chemotherapy.Pearson test was used to analyze the correlation between 5-HT/Pro-GRP and anxiety/depression in patients with small cell lung cancer before and after chemotherapy.The diagnostic efficacy of5-HT and Pro-GRP in post-chemotherapy depression was analyzed by ROC curve.There was significant difference between the two groups when P < 0.05.Results:1.In this study,22 patients with small cell lung cancer were enrolled in the study,including 15 males and 7 females.The mean age was 60.55.±7.33 years old,and the age range from 48 to 72 years.The patients were divided into two groups according to age greater than or equal to 65 years old and less than 65 years old.The differences ofSAS/SDS score before and after chemotherapy between the two groups were compared.Males and females was divided into two groups.The differences of SAS/SDS score before and after chemotherapy were compared between the two groups.The results showed that there was no significant difference in SAS/SDS score between different age groups and gender groups before and after chemotherapy.2.8 patients with small cell lung cancer had depression before chemotherapy,the incidence of depression was 36.4% in the patients with small cell lung cancer.6 patients with small cell lung cancer had anxiety before chemotherapy,the incidence of anxiety was 27.3%.11 patients with small cell lung cancer had depression after chemotherapy,and the rate of depression was 50%.8 patients with small cell lung cancer had anxiety after chemotherapy,the incidence of anxiety was 36.4%.Compared with those before and after chemotherapy,it was found that the incidence of depression and anxiety after chemotherapy was higher than that before chemotherapy.3.The level of serum 5-HT in patients with small cell lung cancer was 1.55±0.21ng/ml before chemotherapy and 1.38±0.32 ng/ml after chemotherapy.Compared with pre-chemotherapy,the serum 5-HT level in patients with small cell lung cancer was significantly lower than that before chemotherapy.The statistical analysis of t-test showed significant difference(P < 0.05).The content of Pro-GRP was 0.80±0.10pg/ml before chemotherapy and 0.64±0.11pg/ml after chemotherapy in patients with small cell lung cancer.Compared with that before chemotherapy,the content of Pro-GRP in patients with small cell lung cancer was significantly lower than that before chemotherapy.The statistical analysis of t-test showed significant difference(P < 0.05).4.SAS scores before chemotherapy were 42.32±7.80,SDS scores before chemotherapy were 46.50±9.21.SAS scores after chemotherapy in patients with small cell lung cancer were 45.50±7.90 and SDS scores were 52.23±8.67.Compared with pre-chemotherapy,the scores of SAS/SDS after chemotherapy were higher than thosebefore chemotherapy.The statistical analysis of t-test showed SDS scores of patients with small cell lung cancer before and after chemotherapy were significantly different(P < 0.05),but there was no significant difference in SAS scores before and after chemotherapy(P > 0.05).5.Pearson test showed that the level of serum 5-HT was negatively correlated with the score of SAS before chemotherapy in patients with small cell lung cancer(r =-0.565,P < 0.05),but there was no correlation between the content of 5-HT and the score of SDS before chemotherapy.There was no correlation between the content of Pro-GRP and SAS/SDS score before chemotherapy.The levels of serum 5-HT(r =-0.451,P < 0.05)and Pro-GRP(r =-0.437,P < 0.05)were negatively correlated with the score of SDS in patients with small cell lung cancer after chemotherapy,but there was no correlation between the level of 5-HT/Pro-GRP and the score of SAS in patients with small cell lung cancer after chemotherapy.There was a negative correlation between the levels of serum 5-HT and anxiety in patients with small cell lung cancer before chemotherapy,and between 5-HT/Pro-GRP and the score of SDS in patients with small cell lung cancer after chemotherapy.6.SDS was used to evaluate the degree of depression in patients with small cell lung cancer after chemotherapy.They were divided into depression group(standard score greater than or equal to 50 points)and non-depression group(standard score less than 50 points).The ROC curve showed that the Area under the working characteristic curve(AUC)of 5-HT and Pro-GRP in identifying subjects with or without depression groups was 0.798 and 0.723.5-HT threshold was 1.508ng/ml,the sensitivity for diagnosis of depression was 63.6%,and the specificity was 91.9%.Pro-GRP threshold was 0.660pg/ml,The sensitivity and specificity in the diagnosis of depression were63.6% and 81.8% respectively.5-HT and Pro-GRP have good diagnostic efficacy in the diagnosis of depression.Conclusion: 1.In patients with small cell lung cancer,the incidence of anxiety anddepression after primary chemotherapy was higher than that before chemotherapy.2.In patients with small cell lung cancer,The content of 5-HT and Pro-GRP in the patients with small cell lung cancer after chemotherapy was significantly lower than that before chemotherapy.3.In patients with small cell lung cancer,the decrease of serum 5-HT and Pro-GRP levels after initial chemotherapy may be one of the causes of depression.