Levels Of Cancer Related Fatigue And The Correlation Between It And Inflammatory Factors And Hypothalamus Pituitary Adrenal Axis In Patients With Gastrointestinal Cancer

ObjectiveThe aim of this study was to assess the fatigue status of patients with gastrointes tinal cancer.we also measure the inflammatory factors in serum,including interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factorα(TNF-α),C reactive protein(CRP)and the hypothalamic pituitary adrenal axis(hypothalamic pituitary adrenal axis),namely the HPA axis,which includs cortisol(CORT)adrenocorticotropic hormone(ACTH)and norepinephrine(NE)levels),So we can investigate the levels of cancer related fatigue and the correlation between it and inflammatory factors and hypothalamus pituitary adrenal axis(HPA axis),exploring the correlation between them and to provide the basis for clinical treatment of CRF.Methods1.A total of patients with gastrointestinal cancer are admitted to the Department of oncology in Shandong province from March to March-8 in 2016.The fatigue was assessed by The Brief Fatigue Inventory(BFI).2.We collect venous blood 3-5ml in the morning from 6:30 to 8:00,labeled patients bed number,name and hospital number,placed in the coagulation tube,centrifuging 8 minutes and the speed is 3000r/min,separation of serum,and put in the refrigerator-80℃ storage.we also use immunoturbidimetry to measure C reactive protein(CRP)and electrochemiluminesence to measure cortisol(CORT),interleukin-6,interleukin-1β,tumor necrosis factor-α,adrenocorticotropic hormone and norepinephrine levels are measured by Elisa.3.The data were analyzed with SPSS 20.0 statistical software,statistical methods including descriptive statistical analysis,independent samples t test,variance analysis,single factor analysis,Spearman and Logistic regression analysis,the difference was statistically significant when P<0.05.Results1.The score of CRF in cancer patients was(3.15±1.93).The t test or analysis of variance results showed that cancer patients with CRF score was statistically significant in age,educational level,family economic status,place of residence,disease duration,ECOG score and receiving treatment(P<0.05).2.Spearman correlation analysis showed that the serum CRP level was positively correlated with the CRF score(P<0.01),and there was no significant correlation between other inflammatory markers and CRF score.3.Spearman correlation analysis showed that CRF score was positively correlated with serum CORT level(P<0.01),and ACTH(P<0.05).4.The regression analysis showed that ECOG score,family economic status,education level,age,place of residence,CRP entered the regression equation,regression equation explained 69.7% of the total variation of CRF.Conclusion1.The incidence of CRF is higher in patients with gastrointestinal cancer,and the symptom ms of fatigue are more prominent,which medical workers should pay attention to.The level of CRP in serum was closely related to the CRF score of patients,the higher the CRP level,the more severe in patients.2.The levels of CORT and ACTH in serum were positively correlated with fatigue,and the HPA axis played an indispensable role in the occurrence of CRF.3.ECOG score,family economic status,education level,age,place of residence,CRP is an important predictor of CRF,patients with fatigue will ease when sleep quality and mental health improved,medical workers are not only focus on the health of patients,but also should pay attention to improve the mental health level of patients.