Interleukin-6, cortisol, and depressive symptoms in ovarian cancer patients - PubMed (original) (raw)

. 2008 Oct 10;26(29):4820-7.

doi: 10.1200/JCO.2007.14.1978. Epub 2008 Sep 8.

Aliza Z Weinrib, Frank Penedo, Daniel Russell, Koen DeGeest, Erin S Costanzo, Patrick J Henderson, Sandra E Sephton, Nicolas Rohleder, Joseph A Lucci 3rd, Steven Cole, Anil K Sood, David M Lubaroff

Affiliations

Interleukin-6, cortisol, and depressive symptoms in ovarian cancer patients

Susan K Lutgendorf et al. J Clin Oncol. 2008.

Abstract

Purpose: Inflammatory processes have been implicated in the pathogenesis of both depression and cancer. Links between depressive symptoms, interleukin-6 (IL-6), and cortisol dysregulation have been demonstrated in cancer patients, but vegetative versus affective components of depression have been minimally examined. The objective of the current study was to examine associations between IL-6, diurnal cortisol rhythms, and facets of depression in epithelial ovarian cancer patients.

Patients and methods: Patients awaiting surgery for a pelvic mass suspected for ovarian cancer completed questionnaires, collected salivary samples for 3 days presurgery, and gave a presurgical blood sample. Ascites was obtained during surgery. IL-6 was measured by enzyme-linked immunosorbent assay and cortisol by a chemiluminescence immunoassay. The final sample included 112 invasive ovarian cancer patients (86 advanced stage, 26 early stage) and 25 patients with tumors of low malignant potential (LMP).

Results: Advanced-stage ovarian cancer patients demonstrated elevations in vegetative and affective depressive symptoms, plasma IL-6, and the cortisol area under the curve (AUC) compared with patients with LMP tumors (all P < .05). Among invasive ovarian cancer patients, greater vegetative depression was related to elevated IL-6 in plasma (P = .008) and ascites (P = .024), but affective depression was unrelated to IL-6. Elevations in total depression (P = .026) and vegetative depression (P = .005) were also related to higher evening cortisol levels. Plasma IL-6 was related to greater afternoon and evening cortisol and cortisol AUC (all P values < .005).

Conclusion: These results demonstrate significant relationships between IL-6, cortisol, and vegetative depression, and may have implications for treatment of depression in ovarian cancer patients.

PubMed Disclaimer

Figures

Fig 1.

Fig 1.

Age-adjusted means (and SE bars) for Center for Epidemiologic Studies-Depression Scale (CES-D) among advanced- and early-stage invasive ovarian cancer patients and patients with tumors of low malignant potential (LMP). (A) CES-D total, (B) positive mood subscale, (C) vegetative depression subscale, (D) depressive mood subscale, and (E) depressive interaction subscale. All significance levels are Bonferroni adjusted.

Fig 2.

Fig 2.

Means and (SE bars) for (A) plasma interleukin-6 (IL-6) (pg/mL) and (B) cortisol area under the curve (AUC) in advanced- and early-stage invasive ovarian cancer patients and in patients with tumors of low malignant potential (LMP). All significance levels are Bonferroni adjusted.

Fig 3.

Fig 3.

Vegetative depression and interleukin-6 (IL-6; pg/mL) in (A) peripheral blood (β = .27, P = .008) and (B) ascites (β = .31, P = .024) in invasive ovarian cancer patients. Stage 1 (circle), stage 2 (square), stage 3 (triangle), stage 4 (diamond). All analyses adjust for age and cancer stage. Regression line is representative of all stages of disease.

Similar articles

Cited by

References

    1. Massie MJ: Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 32:57-71, 2004 - PubMed
    1. Spoletini I, Gianni W, Repetto L, et al: Depression and cancer: An unexplored and unresolved emergent issue in elderly patients. Crit Rev Oncol Hematol 65:143-155, 2008 - PubMed
    1. American Cancer Society: Cancer Facts and Figures. Atlanta, GA, American Cancer Society, 2008
    1. Bodurka-Bevers D, Basen-Engquist K, Camark CL, et al: Depression, anxiety, and quality of life in patients with epithelial ovarian cancer. Gyn Oncol 78:302-308, 2000 - PubMed
    1. Norton TR, Manne SL, Rubin S, et al: Prevalence and predictors of psychological distress among women with ovarian cancer. J Clin Oncol 22:919-926, 2004 - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources