Associations Between Cytokine Genes and a Symptom Cluster of Pain, Fatigue, Sleep Disturbance, and Depression in Patients Prior to Breast Cancer Surgery

Abstract

Pain, fatigue, sleep disturbance, and depression are common and frequently co-occurring symptoms in oncology patients. This symptom cluster is often attributed to the release of pro-inflammatory cytokines. The purposes of this study were to determine whether distinct latent classes of patients with breast cancer (n = 398) could be identified based on their experience with this symptom cluster, whether patients in these latent classes differed on demographic and clinical characteristics, and whether variations in cytokine genes were associated with latent class membership. Three distinct latent classes were identified: All Low (61.0%), Low Pain and High Fatigue (31.6%), All High (7.1%). Compared to patients in the All Low class, patients in the ALL High class were significantly younger, had less education, were more likely to be non-White, had a lower annual income, were more likely to live alone, had a lower functional status, had a higher comorbidity score, and had more advanced disease. Significant associations were found between interleukin (IL) 6 rs2069845, IL13 rs1295686, and tumor necrosis factor alpha rs18800610 and latent class membership. Findings suggest that variations in pro- and anti-inflammatory cytokine genes are associated with this symptom cluster in breast cancer patients.

Patient factors and quality of life outcomes differ among four subgroups of oncology patients based on symptom occurrence

“…In all 13 studies, subgroups of patients who reported a low and high number of symptoms were found. In the studies that reported three [7,8,10,12,14,15], four [5,6,11], or five [13] subgroups, the distinguishing characteristics of the subgroups of patients with moderate symptoms were highly variable in terms of the number and types of symptoms, as well as in the specific demographic and clinical characteristics that distinguished among these subgroups.…”

“…To date, 13 studies were found that used a variety of analytic approaches to classify oncology patients based on their symptom experience [3][4][5][6][7][8][9][10][11][12][13][14][15]. Across these studies, two [3,4,9] to five [13] groups of patients were identified.…”

“…However, the number of symptoms used in these LCAs varied from four [7,[12][13][14]] to 25 [10]. All except one [8] of the 13 studies evaluated for differences in demographic and clinical characteristics among the latent classes.…”

“…In the earliest studies [3][4][5][6], cluster analysis was used to create the patient groups, while in subsequent studies [7][8][9][10][11][12][13][14][15], latent class analysis (LCA) was used to identify subgroups of patients with distinct symptom profiles. However, the number of symptoms used in these LCAs varied from four [7,[12][13][14]] to 25 [10].…”

Variação longitudinal da qualidade do sono em mulheres com câncer de mama

“…Breast cancer is presented in literature as commonly related to several symptoms, such as depression, pain, fatigue, and sleep quality. (16,17) The proportion of women who had poor sleep quality was predominant over the course of the follow-up. Towards the end of follow-up, poor sleep quality persisted and showed a percentage increase in the incidence, similarly to the findings in another research study including 166 women with breast cancer.…”