Background: The incidence of lung cancer is increasing annually. Clinicians pay special attention to lung tests during physical examinations. Due to the popularity of low-dose computed tomography, not only can lung cancer be diagnosed early, but physical examinations often reveal the presence of pulmonary nodules, an important health issue that cannot be ignored. Patients with pulmonary nodules are prone to adverse emotions such as anxiety and depression. Many studies have shown that patients with emotional disorders have immune system dysfunction and changes in inflammation levels. This study aimed to investigate the changes in anxiety, depression, the ratios of T helper cells 17 (Th17) and regulatory T cells (Tregs), and inflammation levels in patients with pulmonary nodules.
Methods: A total of 143 subjects from The First Affiliated Hospital of Anhui Medical University were included from April 2019 to July 2019. All of the subjects were assessed with the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II). Overall, 40 cases were healthy controls (HC) and 103 cases were patients with pulmonary nodules. The patients were divided into two groups according to the scale scores: 62 cases in a non-anxiety and non-depression (NAD) group and 41 cases in an anxiety and/or depression (AD) group. The percentage of Th17 and Tregs in the peripheral blood and inflammatory factors in the serum were detected. The absolute Th17 cell counts were calculated and the differences between the groups and correlations between these indicators were analyzed.
Results: There were statistically significant differences in the percentage of Th17 cells, the absolute counts of Th17 and Th17/Treg cells, and the levels of interleukin-2 (IL-2), IL-6, and tumor necrosis factor-α (TNF-α) among three groups (all P<0.001). The AD group was higher than the HC and NAD groups (all P<0.05). There was no statistically significant difference between the HC and NAD groups (all P>0.05). The previously described indicators had no significant correlation with the severity of anxiety and depression (P>0.05). There were no significant differences in the percentage of Tregs or levels of IL-4 and IL-10 between the groups (all P>0.05). The proportion of anxiety and/or depression in female patients with pulmonary nodules was higher than that in males (P<0.05).
Conclusions: Patients with pulmonary nodules are prone to varying degrees of anxiety and depression, which leads to immune dysfunction and low-grade inflammation.
【中文题目：肺结节患者焦虑抑郁与Th17/Treg 和炎症水平改变的相关性研究】 【中文摘要：背景与目的 肺癌的发病率逐年攀升，人们在体检时尤其注重对肺进行检查，得益于低剂量计算机断层扫描技术的普及，不仅肺癌能够得到早期诊断，很多肺结节也在体检时被发现，并成为当下不可忽视的重要健康问题。肺结节患者极易出现焦虑、抑郁等不良情绪，研究表明情绪障碍患者存在机体免疫功能失调和炎症水平变化，本研究旨在探讨肺结节患者焦虑抑郁与Th17/Treg和炎症水平改变的相关性。方法 纳入2019年4月-2019年7月就诊于安徽医科大学第一附属医院门诊受试者共143例，采用贝克焦虑量表（Beck Anxiety Inventory, BAI）、贝克抑郁量表第二版（Beck Depression Inventory-II, BDI-II）进行评估。其中健康对照（healthy control, HC）组40例；肺结节患者103例，依据量表评分分为焦虑和（或）抑郁（anxiety and/or depression, AD）组41例和无焦虑抑郁（non-anxiety and non-depression, NAD）组62例。检测外周血辅助性T细胞17（T helper cell 17, Th17）、调节T细胞（regulatory T cells, Tregs）百分比，计算Th17细胞绝对值；检测血清炎症因子，并分析组间差异及相关性。结果 三组间Th17细胞百分比、Th17细胞绝对数、Th17/Treg、白细胞介素-2（interleukin-2, IL-2）、IL-6、肿瘤坏死因子-α（tumor necrosis factor-α, TNF-α）水平的差异有统计学意义（均P<0.001），AD组高于HC组和NAD组（均P<0.05），HC组和NAD组间差异无统计学意义（均P>0.05）。以上指标与焦虑、抑郁的严重程度无显著相关性（P>0.05）。Tregs百分比、IL-4、IL-10水平在各组间差异无统计学意义（均P>0.05）。女性肺结节患者焦虑和（或）抑郁比例高于男性（P<0.05）。结论 肺结节患者易出现不同程度的焦虑、抑郁的情绪变化，进而导致机体出现免疫功能失调和低级别炎症。】 【中文关键词：肺结节；焦虑；抑郁；免疫细胞；炎症】.
Keywords: Anxiety; Depression; Immunity cellular; Inflammation; Pulmonary nodules.