乳腺癌相关上肢淋巴水肿的同期症状网络:网络分析。
Contemporaneous Symptom Networks of Breast Cancer-Related Upper Limb Lymphedema: A Network Analysis.
发表日期:2024 Jul 03
作者:
Aomei Shen, Wanmin Qiang, Hongmeng Zhao, Gyumin Han, Peipei Wu, Zijuan Zhang, Qian Hu, Qian Lu
来源:
ANNALS OF SURGICAL ONCOLOGY
摘要:
上肢淋巴水肿 (ULL) 是乳腺癌幸存者 (BCS) 的常见并发症。患有 ULL 的乳腺癌幸存者报告了多种症状。然而,人们对症状模式及其相互关系知之甚少。本研究旨在探索 BCS 中 ULL 相关症状的症状群并构建症状网络,并确定核心症状。本研究是利用中国 BCS 的三项横断面研究的数据集进行的二次数据分析。总共纳入了 341 名最大肢间周长≥2 cm 且乳腺癌和淋巴水肿症状体验指数第 I 部分完全缓解的参与者。通过主成分分析确定症状群,并采用多元线性回归分析来探索与总体 ULL 相关症状严重程度相关的因素。在控制协变量后,构建了包含 20 个经常报告的症状的同期网络。确定了三个症状群,包括淋巴淤滞症状群、神经症状群和运动受限症状群。术后时间、腋窝淋巴结清扫和放疗与 ULL 相关症状的严重程度相关。在有和没有协变量的两个网络中,紧绷感(rs = 1.379;rscov = 1.097)、刺痛感(rs = 1.264;rscov = 0.925)和坚硬感(rs = 1.170;rscov = 0.923)是最核心的症状。 ULL 经历了严重的症状负担。紧绷、刺痛和坚硬是 BCS 中 ULL 的核心症状。我们的研究结果表明,对特定核心症状的评估和有针对性的干预可能有助于有效缓解 BCS 中 ULL 相关症状的负担。© 2024。外科肿瘤学会。
Upper limb lymphedema (ULL) is a common and deliberating complication for breast cancer survivors (BCSs). Breast cancer survivors with ULL reported a wide range of symptoms. However, little is known about symptom patterns and interrelationships among them. This study was designed to explore symptom clusters and construct symptom networks of ULL-related symptoms among BCSs and to identify the core symptoms.This study is a secondary data analysis using datasets from three cross-sectional studies of BCSs in China. A total of 341 participants with maximum interlimb circumference ≥2 cm and complete responses in Part I of the Breast Cancer and Lymphedema Symptom Experience Index were included. Symptom clusters were identified through principal component analysis, and multiple linear regression analysis was employed to explore factors associated with severity of overall ULL-related symptoms. A contemporaneous network with 20 frequently reported symptoms were constructed after controlling for covariates.Three symptom clusters, including lymph stasis symptom cluster, nerve symptom cluster, and movement limitation symptom cluster, were identified. Postsurgery time, axillary lymph node dissection, and radiotherapy were associated with the severity of ULL-related symptoms. Tightness (rs = 1.379; rscov = 1.097), tingling (rs = 1.264; rscov = 0.925), and firmness (rs = 1.170; rscov = 0.923) were the most central symptoms in both networks with and without covariates.Breast cancer survivors with ULL experienced severe symptom burden. Tightness, tingling, and firmness were core symptoms of ULL among BCSs. Our findings demonstrated that the assessment and targeted intervention of specific core symptoms might help to relive effectively the burden of ULL-related symptom among BCSs.© 2024. Society of Surgical Oncology.