慢性心理社会压力：在乳腺癌症病因中的作用？

摘要(中文译文)

流行病学与临床前研究在社会心理应激对乳腺癌（BC）发生和转移的作用方面存在差异。尽管基于流行病学研究尚未达成共识，但临床前啮齿动物研究常规采用慢性社会心理应激范式来探讨乳腺癌发生和转移的机制细节。我们旨在综述社会心理应激在乳腺癌发生中的流行病学和临床前研究，重点关注慢性社会心理应激是否可能是一个特别相关的应激源领域。对于临床前啮齿动物研究，我们检索了PubMed中1985年至2025年12月发表的英文单项研究，这些研究评估了慢性社会心理应激对乳腺肿瘤发生和转移的影响。我们将关注范围限制在使用慢性社会心理应激方案的研究。对于乳腺癌社会心理应激的流行病学研究，由于文献丰富且跨越数十年，我们检索了Medline（PubMed）中过去三十年（1995年至2025年12月）发表的英文系统综述和荟萃分析，其中询问了参与者对社会心理应激的暴露情况。系统文献检索确定了29项将啮齿动物随机分配至慢性社会心理应激或安全组的啮齿动物研究。29项研究中有25项发现慢性社会心理应激增加了乳腺肿瘤发生和/或转移，其余研究报告了更为复杂的效果，反映了研究设计要素的差异。相比之下，14项流行病学研究系统综述和荟萃分析中纳入的大多数原始研究聚焦于短暂的不良生活事件，未检测到与乳腺癌的一致关联。流行病学研究仅部分且非系统地涉及了慢性社会心理应激。临床前啮齿动物研究的结果表明，慢性社会心理应激可能是乳腺癌发生中特别相关的社会心理暴露领域。相比之下，我们综述的流行病学研究主要聚焦于急性不良生活事件，对慢性社会心理应激的关注有限。我们认为，这些证据凸显了在未来的乳腺癌病因学流行病学研究中优先关注慢性社会心理应激的必要性。可操作的方法学组成部分可能包括：应激暴露的生命历程视角、多层次社会互动视角、同时纳入慢性和急性应激及其相互作用，以及纳入个体对痛苦的主观评价。

Abstract

Epidemiological and preclinical studies are discrepant regarding the role of psychosocial stress in breast cancer (BC) development and metastasis. While no consensus has been reached based on epidemiological studies, preclinical rodent studies regularly employ chronic psychosocial stress paradigms to study mechanistic details in mammary carcinogenesis and metastasis. We aimed to review both epidemiological and preclinical studies of psychosocial stress in BC development, focusing on whether chronic psychosocial stress might be a particularly relevant stressor domain. For preclinical rodent studies, we searched PubMed for individual studies from 1985 to December 2025 written in English that evaluated effects of chronic psychosocial stress on mammary tumorigenesis and metastasis. We restricted focus to studies that used chronic psychosocial stress protocols. For epidemiological research into psychosocial stress in BC, due to the abundant literature that spans several decades, we searched Medline (PubMed) for English-language systematic reviews and meta-analyses published in the last three decades (1995 to December 2025) in which participants were inquired about exposure to psychosocial stress. Systematic literature searches identified 29 rodent studies that randomly allocated rodents to chronic psychosocial stress or safety. Twenty-five of the 29 studies found that chronic psychosocial stress increased mammary tumorigenesis and/or metastasis, with the remaining studies reporting more complex effects that reflected variations in study design elements. In contrast, most original research studies included in 14 systematic reviews and meta-analyses of epidemiological research focused on short-lasting, adverse life events, with no consistent associations detected with BC. Epidemiological studies have only partly and unsystematically addressed chronic psychosocial stress. Findings from preclinical rodent studies indicate that chronic psychosocial stress may be a particularly relevant psychosocial exposure domain in BC development. In contrast, the epidemiological studies we reviewed focused predominantly on acute adverse life events, with limited attention to chronic psychosocial stress. We suggest that this evidence highlights the need to prioritize chronic psychosocial stress in future epidemiological studies of BC etiology. Actionable method components may include a life-course perspective for stress exposure, a multi-level social interaction perspective, inclusion of both chronic and acute stress and their interactions, and inclusion of individuals' subjective appraisals of distress.

如何引用

Frontiers in oncology 的其他文献

• 单孔腹腔镜在妇科恶性肿瘤腹膜后淋巴结切除术中的应用及研究进展
• 综合全身免疫炎症指数和预后营养指数的化疗前列线图的开发和验证，以预测结直肠癌癌症的严重佐剂毒性
• 雄激素受体表达在ER阳性/HER2阴性乳腺癌症中的预后价值：来自当代中国队列的证据
• ESCC术后患者5年生存预测模型的构建与验证
• 一种新的液-液cfDNA提取方法，用于大肠癌癌症患者样本的靶向测序：一项中试研究
• 瘤内和瘤周放射组学用于预测乳腺癌症对比增强乳房X光检查中的可疑HER2状态
• 基于超声的放射组学和栖息地分析用于乳腺癌症中Ki-67过度表达的无创评估
• 人工智能介导的超声影像组学在三阴性乳腺癌诊断和治疗中的研究进展与未来挑战
• 使用随机森林算法的基于放射学的骨盆软骨肉瘤鉴别诊断模型
• 预测接受TACE联合靶向免疫治疗的中晚期肝细胞癌的肿瘤进展