巨细胞病毒感染与卵巢癌幸存者的癌相关认知障碍和周围神经病变的关系

Associations of cytomegalovirus infection with cancer-related cognitive impairment and peripheral neuropathy in ovarian cancer survivors

GYNECOLOGIC ONCOLOGY

影响因子:4.1

分区:医学2区 Top / 妇产科学1区肿瘤学2区

发表日期:2024 Dec

作者: Xuan Li, Peter A Argenta, Katherine Brown, Kate Honeyfield, Devon Hunter-Schlichting, Morgan Gruner, Deanna Teoh, Lauren C Peres, Melissa Geller, Heather H Nelson, Rachel I Vogel

DOI: 10.1016/j.ygyno.2024.09.016

摘要

本研究旨在评估 active CMV感染与卵巢癌幸存者报告的癌相关认知障碍（CRCI）和周围神经病变症状之间的关系。我们在接受一线化疗后任何时间点，来自学术和社区肿瘤诊所的卵巢癌、原发性腹膜癌或输卵管癌患者中进行横断面研究。参与者完成一次性问卷并提供血样。通过数字PCR测定血浆病毒DNA水平，≥100拷贝/mL视为活跃感染（CMV+，EBV+作为对照）。使用Patient-Reported Outcomes Measurement Information System（PROMIS）认知功能短表8a和肿瘤治疗/妇科肿瘤组神经毒性（FACT/GOG-NTX）子量表测量CRCI和神经病变症状。将症状与活跃CMV感染状态进行比较，使用t检验和线性回归模型。共纳入152名参与者，其中59人（38.8%）为CMV+。调整潜在混杂因素后，CMV+患者自报神经病变症状明显多于CMV-（p=0.04）。在当前接受化疗的亚组中，CMV+患者的认知感知水平显著低于CMV-（p=0.03），但在整体群体中未观察到此差异。未发现与EBV感染相关的显著关联。活跃CMV感染在此幸存者群体中较为常见，并可能与CRCI和神经病变症状的增加有关。

Abstract

To assess the associations between active CMV infection and patient-reported symptoms of cancer-related cognitive impairment (CRCI) and peripheral neuropathy in ovarian cancer survivors.We conducted a cross-sectional study among individuals with a diagnosis of ovarian cancer, primary peritoneal cancer, or fallopian tube cancer from academic and community cancer clinics at any time point after completion of front-line chemotherapy. Participants completed a one-time survey and provided a blood sample. Plasma virus DNA levels were measured using digital PCR, with ≥100 copies/mL of plasma considered active infection (CMV+, EBV+ as a control). We measured symptoms of CRCI and peripheral neuropathy using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function short form 8a and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT/GOG-NTX) subscale measurements, respectively. Symptoms were compared by active CMV infection status in the full group and among the subgroup receiving active treatment using t-tests and linear regression models.152 participants were included. A total of 59 (38.8 %) participants were CMV+. After adjustment for potential confounding variables, individuals who were CMV+ self-reported significantly more symptoms of peripheral neuropathy that those who were CMV- (p = 0.04). In the subgroup of participants currently receiving chemotherapy, individuals who were CMV+ had significantly lower perceived cognitive functioning compared to individuals who were CMV- (p = 0.03); this was not observed in the full cohort. No associations were observed between outcomes and EBV infection.Active CMV infection is common in this survivor population and may be associated with more symptoms of CRCI and neuropathy.