BACKGROUND Adults who undergo chronic stress, such as the diagnosis and surgical treatment of breast cancer, often experience adjustment difficulties and important biologic effects. This stress can affect the immune system, possibly reducing the ability of individuals with cancer to resist disease progression and metastatic spread. We examined whether stress influences cellular immune responses in patients following breast cancer diagnosis and surgery. METHODS We studied 116 patients recently treated surgically for invasive breast cancer. Before beginning their adjuvant therapy, all subjects completed a validated questionnaire assessing the stress of being cancer patients. A 60-mL blood sample taken from each patient was subjected to a panel of natural killer (NK) cell and T-lymphocyte assays. We then developed multiple regression models to test the contribution of psychologic stress in predicting immune function. All regression equations controlled for variables that might exert short- or long-term effects on these responses, and we also ruled out other potentially confounding variables. RESULTS We found, reproducibly between and within assays, the following: 1) Stress level significantly predicted lower NK cell lysis, 2) stress level significantly predicted diminished response of NK cells to recombinant interferon gamma, and 3) stress level significantly predicted decreased proliferative response of peripheral blood lymphocytes to plant lectins and to a monoclonal antibody directed against the T-cell receptor. CONCLUSIONS The data show that the physiologic effects of stress inhibit cellular immune responses that are relevant to cancer prognosis, including NK cell toxicity and T-cell responses. Additional, longitudinal studies are needed to determine the duration of these effects, their health consequences, and their biologic and/or behavioral mechanisms.

中文翻译：

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局部乳腺癌手术治疗后的应激和免疫反应。


背景技术承受慢性压力（例如乳腺癌的诊断和手术治疗）的成年人经常会经历适应困难和重要的生物效应。这种压力会影响免疫系统，可能会降低癌症患者抵抗疾病进展和转移扩散的能力。我们研究了压力是否会影响乳腺癌诊断和手术后患者的细胞免疫反应。方法 我们研究了 116 名最近接受手术治疗的浸润性乳腺癌患者。在开始辅助治疗之前，所有受试者都完成了一份经过验证的问卷，以评估癌症患者的压力。从每位患者身上抽取 60 mL 血样，进行一系列自然杀伤 (NK) 细胞和 T 淋巴细胞检测。然后，我们开发了多元回归模型来测试心理压力在预测免疫功能中的贡献。所有回归方程都控制了可能对这些响应产生短期或长期影响的变量，并且我们还排除了其他潜在的混杂变量。结果 我们发现，在测定之间和测定内可重复地发现以下情况：1) 应激水平显着预测 NK 细胞裂解较低，2) 应激水平显着预测 NK 细胞对重组干扰素 γ 的反应减弱，3) 应激水平显着预测增殖反应降低外周血淋巴细胞转化为植物凝集素和针对 T 细胞受体的单克隆抗体。结论 数据显示，压力的生理效应会抑制与癌症预后相关的细胞免疫反应，包括 NK 细胞毒性和 T 细胞反应。 此外，还需要进行纵向研究来确定这些影响的持续时间、其健康后果及其生物学和/或行为机制。