大约三分之一的乳腺癌幸存者存在持续的认知问题和客观认知障碍。慢性炎症和肠道通透性（即"漏肠"）是导致认知下降的两个风险因素，并且还可加剧与认知下降相关的抑郁情绪。本研究旨在测试乳腺癌幸存者中伴有高水平炎症或肠道通透性的抑郁情绪是否预测主观和客观认知功能水平较低。我们合并了四个乳腺癌幸存者研究的数据（n=613），其中一些研究进行了多次测量，共计1015次研究访问。所有参与者均进行了血液采集以获得基线的脂多糖结合蛋白测量值-肠道通透性的一种衡量，同时还获得了三种炎症标志物的测量值，这些标志物被整合成了一个炎症指数：C-反应蛋白、白细胞介素-6和肿瘤坏死因子-α。参与者根据流行病学调查抑郁量表（CES-D）报告抑郁症状，并使用二元变量来指示临床上显著的抑郁症状（CES-D ≥ 16）。Kohli（749次观察）和乳腺癌预防试验（591次观察）量表评估主观认知功能。客观认知功能测试包括追踪测试、霍普金斯口头学习测试、康纳持续性能力测试、n-back测试、FAS测试和命名动物测试（239-246次观察）。在调整教育程度、年龄、BMI、癌症治疗类型、治疗之后时间、研究访问和疲劳的基础上，伴有增强炎症或肠道通透性的临床上显著抑郁症状的女性报告的注意力较差，记忆稍差。然而，客观认知测量方面的较差表现并不特定于与炎症相关的抑郁症。相反，有一些证据表明，无论有无炎症，抑郁幸存者在口头流畅性、注意力、口头学习和记忆、工作记忆以及视空间搜索方面都存在困难。独立地看，炎症和肠道通透性不太一致地预测主观或客观认知功能。乳腺癌幸存者如果伴有临床上显著的抑郁症状，无论是伴有增强炎症还是肠道通透性，其可能会感觉到认知困难较大，尽管与炎症相关的抑郁引起的客观认知缺陷可能不专门特定于炎症或"漏肠"相关的抑郁症。

About one-in-three breast cancer survivors have lingering cognitive complaints and objective cognitive impairment. Chronic inflammation and intestinal permeability (i.e., leaky gut), two risk factors for cognitive decline, can also fuel depression-another vulnerability for cognitive decline. The current study tested whether depression accompanied by high levels of inflammation or intestinal permeability predicted lower subjective and objective cognitive function in breast cancer survivors. We combined data from four breast cancer survivor studies (n = 613); some had repeated measurements for a total of 1015 study visits. All participants had a blood draw to obtain baseline measures of lipopolysaccharide binding protein-a measure of intestinal permeability, as well as three inflammatory markers that were incorporated into an inflammatory index: C-reactive protein, interleukin-6, and tumor necrosis factor-α. They reported depressive symptoms on the Center for Epidemiological Studies depression scale (CES-D), and a binary variable indicated clinically significant depressive symptoms (CES-D ≥ 16). The Kohli (749 observations) and the Breast Cancer Prevention Trial (591 observations) scales assessed subjective cognitive function. Objective cognitive function tests included the trail-making test, Hopkins verbal learning test, Conners continuous performance test, n-back test, FAS test, and animal-naming test (239-246 observations). Adjusting for education, age, BMI, cancer treatment type, time since treatment, study visit, and fatigue, women who had clinically elevated depressive symptoms accompanied by heightened inflammation or intestinal permeability reported poorer focus and marginally poorer memory. However, poorer performance across objective cognitive measures was not specific to inflammation-associated depression. Rather, there was some evidence of lower verbal fluency; poorer attention, verbal learning and memory, and working memory; and difficulties with visuospatial search among depressed survivors, regardless of inflammation. By themselves, inflammation and intestinal permeability less consistently predicted subjective or objective cognitive function. Breast cancer survivors with clinically significant depressive symptoms accompanied by either elevated inflammation or intestinal permeability may perceive greater cognitive difficulty, even though depression-related objective cognitive deficits may not be specific to inflammation- or leaky-gut-associated depression.