Correlations Between Preoperative Behavioral Symptoms And Inflammatory Factors In Patients With Glioma

Objective: Behavioral symptoms,including depression,anxiety and cognitive impairment,are common clinical symptoms of patients with glioma.However,the underlying mechanism of behavioral symptoms in patients with gliomas is still unclear.In this study,we explore the correlation between markers of systemic inflammation and preoperational behavioral symptoms in glioma patients.Methods: From January 2018 to December 2019,suspected glioma patients recruited from the Department of Neurosurgery of the affiliated Hospital of Southwest Medical University became preliminary participants in this study.When they underwent imaging examinations(i.e.CT,MRI),they were told that the imaging results showed suspected gliomas,and after obtaining the consent of the patients and their families,they were initially included in the study.The participants received face-to-face interviews with researchers two days before operation,completed the self-report scale and evaluated the participants with the Depression Behavioral symptom scale,anxiety Behavioral symptom scale and Cognitive Behavioral symptom Scale,and provided fasting blood samples in the morning.Participants with previously identified suspected gliomas were included in the final study after the postoperative pathological diagnosis was confirmed as gliomas.In addition,we detected the concentration of inflammatory cytokines in blood samples by liquid phase chip technology,and used SPSS 22 statistical software for statistical analysis.The continuous variables were analyzed by Mann-Whitney U test or t test,and the classified variables were analyzed by chi-square test.Spearman correlation analysis is used to analyze the association between behavioral symptoms.Results:(1)At the beginning of the study,143 participants suspected of having gliomas were initially included.Finally,a total of 71 glioma patients were screened and eventually participated in the study(71/143,49.7%).Regarding the glioma grade,33 patients had low grade(46.5%)and 38 had high grade glioma(53.5%).Thirty-eight participants(53.5%)had clinically significant symptoms of depression(HAMD≥8).Fifty participants(70.4%)had clinically significant symptoms of anxiety(HAMA ≥ 7).Twenty-three participants had clinically significant symptoms of cognitive impairment(32.4%).(2)The pathological glioma grade had no significant relationship with the behavioral symptoms or inflammatory characteristics(both P > 0.1).The other tumor-related characteristics(side of the lesion,position of tumor,lump size,degree of edema)had no correlation either with the behavioral symptoms or inflammatory factors.(3)The marital status of patients with glioma was correlated with HAMD score(P<0.01).Alternatively,the score of the depression symptoms of married glioma patients was significantly lower than that of unmarried glioma patients.The levels of CRP and IFN-γ correlated positively with the HAMD score(P<0.01;P<0.01).People with higher KPS scores during hospitalization were more likely to be anxious(P< 0.01).A negative correlation was noted between the levels of IL-1 α,IL-2,and GDNF and the HAMA score(P<0.04;P<0.01;P<0.04).The scores of the concentrations of TNF-α and IL-2,IL-8,and GDNF correlated positively with cognitive impairment(P < 0.01,P < 0.01,P < 0.01,P < 0.01),and the concentration of CRP correlated negatively with cognitive impairment(P <0.01).(4)The variables related to the demographic sociological characteristics or biological variables in the univariate analysis were included in the multiple regression analysis for each symptom.Only IFN-γ correlated positively with depressive symptoms(P < 0.01).IL-2 was negatively associated with anxious symptoms(P <0.01),and IL-2 was also significantly positively correlated with cognitive impairment(P <0.01).Conclusion: This study shows that the behavioral symptoms of patients with glioma are related to systemic serum inflammatory factors.This provides further evidence of the contribution of inflammatory markers to psychological symptoms in the context of physical conditions and lays the foundation for the development of further treatments of the behavioral symptoms in glioma patients.