medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2020-29-44-47medalphabet-1752Research ArticleСтатьиАффективные нарушения как предиктор риска развития онкологических заболеваний на примере злокачественных опухолей поджелудочной железыAffective disorders as risk predictor of developing cancer on example of malignant tumors of pancreasПавловскийА. В.PavlovskyA. V.

Доктор медицинских наук, научный руководитель отделения хирургии № 2.Санкт-Петербург.

Saint Petersburg.

МоисеенкоВ. Е.MoiseenkoV. E.

Кандидат медицинских наук врач-хирург, онколог отделения хирургии № 2.Санкт-Петербург.

Saint Petersburg.

ПоповС. А.PopovS. A.

Кандидат медицинских наук, врач-хирург, онколог, зав. отделением хирургии № 2.Санкт-Петербург.

Saint Petersburg.

ГаджиеваФ. Ш.GadzhievaF. Sh.

Врач-психиатр отделения трансляционной психиатрии.Санкт-Петербург.

Saint Petersburg.

РукавишниковГ. В.RukavishnikovG. V.

Кандидат медицинских наук, врач-психиатр отделения трансляционной психиатрии.Санкт-Петербург.

Saint Petersburg.

МазоГ. Э.MazoG. E.

Доктор медицинских наук, научный рук. отделения трансляционной психиатрии.Санкт-Петербург.

Saint Petersburg.

КовенкоА. Е.KovenkoA. E.

Заочный аспирант.Санкт-Петербург.

Saint Petersburg.

Российский научный центр радиологии и хирургических технологий имени академика А.М. Гранова Минздрава РоссииРоссияRussian Scientific Centre of Radiology and Surgical Technologies n.a. academician A.M. GranovRussian FederationНациональный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева Минздрава РоссииРоссияNational Medical Research Centre for Psychiatry and Neurology n.a. V.M. BekhterevRussian Federation202021112020029Диагностика и онкотерапия (3)4447Copyright © Павловский А.В., Моисеенко В.Е., Попов С.А., Гаджиева Ф.Ш., Рукавишников Г.В., Мазо Г.Э., Ковенко А.Е., 20202020Павловский А.В., Моисеенко В.Е., Попов С.А., Гаджиева Ф.Ш., Рукавишников Г.В., Мазо Г.Э., Ковенко А.Е.Pavlovsky A.V., Moiseenko V.E., Popov S.A., Gadzhieva F.S., Rukavishnikov G.V., Mazo G.E., Kovenko A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1752

Рак поджелудочной железы (РПЖ) является 12-м по частоте среди злокачественных новообразований и седьмым по частоте смертельных исходов от рака во всем мире. Ранняя диагностика РПЖ крайне затруднена, так как заболевание долгое время протекает без выраженной клинической симптоматики, а выявление и скрининг так называемых групп риска пациентов затруднены, поскольку этиология РПЖ на сегодняшний день является вопросом научных споров. Ранняя диагностика РПЖ может складываться в том числе и на анамнестическом анализе психоэмоционального статуса больных. Еще в начале XX века исследователи на основании анализа результатов опроса больных РПЖ описали триаду аффективных признаков, включавших в себя депрессию, тревогу и чувство надвигающейся гибели, которые беспокоили больных на ранних этапах развития РПЖ. По данным некоторых авторов, психиатрические симптомы РПЖ могут появляться за 43 месяца до соматических симптомов и встречаются у более чем у 50 % пациентов. На сегодняшний день в литературе существует некоторое количество концепций, в которых отмечается значимый вклад аффективных нарушений в развитие РПЖ. Целью данного обзора является проведение анализа литературных данных о связи аффективных нарушений с развитием РПЖ.

Pancreatic cancer is the 12th most common malignant neoplasm and the 7th most common cancer related death worldwide. Early diagnosis of pancreatic cancer is complicated, since the disease proceeds for a long time without pronounced clinical symptoms, and the identification and screening of the so-called risk groups of patients is difficult, since the etiology of pancreatic cancer is currently a matter of scientific debate. Early diagnosis of pancreatic cancer can be based on the anamnestic analysis of the psychoemotional status of patients. Back in the early 20th century, based on an analysis of the results of a survey of patients with pancreatic cancer, researchers described a triad of affective signs, including depression, anxiety and a sense of impending death, which worried patients in the early stages of development of the disease. According to literature, the psychiatric symptoms of pancreatic cancer can appear 43 months before the somatic symptoms and occur in more than 50 % of patients. To date, there are a number of concepts in the literature that point to a significant contribution of affective disorders to the development of pancreatic cancer. The aim of this review is to analyze the literature data on the relationship between affective disorders and the development of pancreatic cancer.

рак поджелудочной железыранние симптомыстрессаффективные расстройствакомбинированное лечениеpancreatic cancerearly symptomsstressaffective disorderscombined treatmentReferencesAmerican Cancer Society (2013). Cancer facts & figures: Special section-Pancreatic cancer (pp. 25-34). Atlanta, GA: Author.American Cancer Society (2013). Cancer facts & figures: Special section-Pancreatic cancer (pp. 25-34). Atlanta, GA: Author.Yaskin JC (1931) Nervous symptoms as earliest manifestations of carcinoma of the pancreas. JAMA. 96: 1664-1668.Yaskin JC (1931) Nervous symptoms as earliest manifestations of carcinoma of the pancreas. JAMA. 96: 1664-1668.Fras I, Litin EM, Bartholomew LG (1968). Mental symptoms as an aid in the early diagnosis of carcinoma of the pancreas. Gastroenterology. 55: 191-198.Fras I, Litin EM, Bartholomew LG (1968). Mental symptoms as an aid in the early diagnosis of carcinoma of the pancreas. Gastroenterology. 55: 191-198.Fras I, Litin EM, Pearson JS (1967). Comparison of psychiatric symptoms of carcinoma of the pancreas with those in some other intra-abdominal neoplasms. Am J Psychiatry. 123: 1553-1562.Fras I, Litin EM, Pearson JS (1967). Comparison of psychiatric symptoms of carcinoma of the pancreas with those in some other intra-abdominal neoplasms. Am J Psychiatry. 123: 1553-1562.Pitts FN, McClure IN: Lactate metabolism in anxiety neurosis. N Engl J Med 1967; 227: 1329-1336.Pitts FN, McClure IN: Lactate metabolism in anxiety neurosis. N Engl J Med 1967; 227: 1329-1336.Gaffney FA, Fenton BJ, Lane LD, et al. Hemodynamic, ventilatory, and biochemical responses of panic patients and normal controls with sodium lactate infusion and spontaneous panic attacks. Arch Gen Psychiatry 1988; 45: 53-60.Gaffney FA, Fenton BJ, Lane LD, et al. Hemodynamic, ventilatory, and biochemical responses of panic patients and normal controls with sodium lactate infusion and spontaneous panic attacks. Arch Gen Psychiatry 1988; 45: 53-60.Liebowitz MR, Gorman JM, Fyer AJ, et al. Lactate provocation of panic altacks: II. Biochemical and physiological findings. Arch Gen Psychiatry 1985; 42: 709-719.Liebowitz MR, Gorman JM, Fyer AJ, et al. Lactate provocation of panic altacks: II. Biochemical and physiological findings. Arch Gen Psychiatry 1985; 42: 709-719.Carr DB, Sheehan DV. Panic anxiety: a new biological model. J Clin Psychiatry 1984; 45: 323-330.Carr DB, Sheehan DV. Panic anxiety: a new biological model. J Clin Psychiatry 1984; 45: 323-330.Reber HA, Johnson FE, Montgomery C. et al. Pancreatic secretion in hamsters with pancreatic cancer. Surgery 1977; 82: 34-41.Reber HA, Johnson FE, Montgomery C. et al. Pancreatic secretion in hamsters with pancreatic cancer. Surgery 1977; 82: 34-41.Leong ASY. Siavotinek AH. Deakin EJ. The pathology of experimental chronic fibrosing pancreatitis: light microscopic and ultrastructural observations. Pathology 1982; 14: 363-368.Leong ASY. Siavotinek AH. Deakin EJ. The pathology of experimental chronic fibrosing pancreatitis: light microscopic and ultrastructural observations. Pathology 1982; 14: 363-368.Churg A, Richter WR. Early changes in the exocrine pancreas ofthe dog and rat after ligation of the pancreatic duct. Am J PathoI 1971; 63: 521-546.Churg A, Richter WR. Early changes in the exocrine pancreas ofthe dog and rat after ligation of the pancreatic duct. Am J PathoI 1971; 63: 521-546.Green AI, Austen CP (1993). Psychopathology of pancreatic cancer. A psychobiologic probe. Psychosomatics. 34: 208-221.Green AI, Austen CP (1993). Psychopathology of pancreatic cancer. A psychobiologic probe. Psychosomatics. 34: 208-221.Chan C, Lin HJ, Lin J. Stress-associated hormone, norepinephrine, increases proliferation and IL-6 levels of human pancreatic duct epithelial cells and can be inhibited by the dietary agent, sulfora-phane. Int J Oncol. 2008; 33: 415-419.Chan C, Lin HJ, Lin J. Stress-associated hormone, norepinephrine, increases proliferation and IL-6 levels of human pancreatic duct epithelial cells and can be inhibited by the dietary agent, sulfora-phane. Int J Oncol. 2008; 33: 415-419.Schuller HM, Al-Wadei HA, Ullah MF, et al. Regulation of pancreatic cancer by neuro-psychological stress responses: a novel target for intervention. Carcinogenesis. 2012; 33: 191-196.Schuller HM, Al-Wadei HA, Ullah MF, et al. Regulation of pancreatic cancer by neuro-psychological stress responses: a novel target for intervention. Carcinogenesis. 2012; 33: 191-196.Shan T, Ma J, MaQ, et al. e2-AR-HIF-1a: a novel regulatory axis for stress-induced pancreatic tumor growth and angiogenesis. Curr Mol Med. 2013; 13: 1023-1034.Shan T, Ma J, MaQ, et al. e2-AR-HIF-1a: a novel regulatory axis for stress-induced pancreatic tumor growth and angiogenesis. Curr Mol Med. 2013; 13: 1023-1034.Kim-Fuchs C, Le CP, Pimentel MA, et al. Chronic stress accelerates pancreatic cancer growth and invasion: a critical role for beta-adrenergic signaling in the pancreatic microenvironment. Brain Behav Immun. 2014; 40: 40-4Kim-Fuchs C, Le CP, Pimentel MA, et al. Chronic stress accelerates pancreatic cancer growth and invasion: a critical role for beta-adrenergic signaling in the pancreatic microenvironment. Brain Behav Immun. 2014; 40: 40-4Valkanova V, Ebmeier KP, Allan CL. CRP, IL-6 and depression: a systematic review and meta-anal-ysis of longitudinal studies. J Affect Disord. 2013; 150: 736-744.Valkanova V, Ebmeier KP, Allan CL. CRP, IL-6 and depression: a systematic review and meta-anal-ysis of longitudinal studies. J Affect Disord. 2013; 150: 736-744.Tilg H, Dinarello CA, Mier JW. IL-6 and APPs: anti-inflammatory and immunosuppressive mediators. Immunol Today. 1997; 18: 428-432.Tilg H, Dinarello CA, Mier JW. IL-6 and APPs: anti-inflammatory and immunosuppressive mediators. Immunol Today. 1997; 18: 428-432.Sharma RP, Tun N, Grayson DR. Depolarization induces downregulation of DNMT1 and DNMT3a in primary cortical cultures. Epigenetics. 2008; 3: 74-80.Sharma RP, Tun N, Grayson DR. Depolarization induces downregulation of DNMT1 and DNMT3a in primary cortical cultures. Epigenetics. 2008; 3: 74-80.Hwang JP, Tsai SJ, Hong CJ, et al. The Val66Met polymorphism of the brain-derived neurotrophic-factor gene is associated with geriatric depression. Neurobiol Aging. 2006; 27: 1834-1837.Hwang JP, Tsai SJ, Hong CJ, et al. The Val66Met polymorphism of the brain-derived neurotrophic-factor gene is associated with geriatric depression. Neurobiol Aging. 2006; 27: 1834-1837.Miao JW, Liu LJ, Huang J. Interleukin-6-induced epithelial-mesenchymal transition through signal transducer and activator of transcription 3 in human cervical carcinoma. Int J Oncol. 2014; 45: 165-176.Miao JW, Liu LJ, Huang J. Interleukin-6-induced epithelial-mesenchymal transition through signal transducer and activator of transcription 3 in human cervical carcinoma. Int J Oncol. 2014; 45: 165-176.Bellone G, Smirne C, Mauri FA, et al. Cytokine expression profile in human pancreatic carcinoma cells and in surgical specimens: implications for survival. Cancer Immunol Immunother. 2006; 55: 684-698.Bellone G, Smirne C, Mauri FA, et al. Cytokine expression profile in human pancreatic carcinoma cells and in surgical specimens: implications for survival. Cancer Immunol Immunother. 2006; 55: 684-698.Li R, Hou J, Xu Q, et al. High level interleukin-6 in the medium of human pancreatic cancer cell culture suppresses production of neurotransmitters by PC 12 cell line. Metab Brain Dis. 2012; 27: 91-100.Li R, Hou J, Xu Q, et al. High level interleukin-6 in the medium of human pancreatic cancer cell culture suppresses production of neurotransmitters by PC 12 cell line. Metab Brain Dis. 2012; 27: 91-100.Breitbart W, Rosenfeld B, Tobias K, Pessin H, Ku GY, Yuan J, Wolchok J. Depression, cytokines, and pancreatic cancer.Breitbart W, Rosenfeld B, Tobias K, Pessin H, Ku GY, Yuan J, Wolchok J. Depression, cytokines, and pancreatic cancer.Zhang T, Tan XL, Xu Y, et al. Expression and prognostic value of indoleamine 2, 3-dioxygenase in pancreatic cancer. Chin Med J (Engl). 2017; 130: 710-716.Zhang T, Tan XL, Xu Y, et al. Expression and prognostic value of indoleamine 2, 3-dioxygenase in pancreatic cancer. Chin Med J (Engl). 2017; 130: 710-716.Botwinick IC, Pursell L, Yu G, et al. A biological basis for depression in pancreatic cancer. HPB (Oxford). 2014; 16: 740-743.Botwinick IC, Pursell L, Yu G, et al. A biological basis for depression in pancreatic cancer. HPB (Oxford). 2014; 16: 740-743.Malhi GS, Byrow Y, Fritz K, et al. Mood disorders: neurocognitive models. Bipolar Disord. 2015; 17 (suppl 2): 3-20.Malhi GS, Byrow Y, Fritz K, et al. Mood disorders: neurocognitive models. Bipolar Disord. 2015; 17 (suppl 2): 3-20.Inagaki M, Yoshikawa E, Kobayakawa M, et al. Regional cerebral glucose metabolism in patients with secondary depressive episodes after fatal pancreatic cancer diagnosis. J Affect Disord. 2007; 99: 231-236.Inagaki M, Yoshikawa E, Kobayakawa M, et al. Regional cerebral glucose metabolism in patients with secondary depressive episodes after fatal pancreatic cancer diagnosis. J Affect Disord. 2007; 99: 231-236.

The authors declare that there are no conflicts of interest present.