The dependence of situational anxiety and depression from -238(G/A)TNF polymorphism in operable breast cancer patients

Abstract

Depression is a common mental disorder among cancer patients. Tumor necrosis factor (TNF) plays an important role in the pathophysiology of depression. The TNF gene has a single nucleotide polymorphisms -308(G/A) and -238(G/A) which affect the level of TNF protein production. Data on the association of TNF polymorphisms with depression are contradictory and mostly concern -308(G/A), whereas the -238(G/A) in this respect is almost not studied. The aim of this work was to determine the dependence of the severity of situational anxiety and depression from polymorphisms of -308(G/A) and -238(G/A) TNF gene and clinical characteristics of breast cancer (BC). 112 women aged 27 to 76 (mean age 53.3 years) were studied in the first days of stay in the clinic, prior to the operation. The diagnostic procedure was carried out as part of the clinical method based on direct examination of patients and included the analysis of the mental state, subjective and objective medical history information, medical records. The mental state was determined by the Hospital Anxiety and Depression Scale (HADS). Determination of polymorphisms was performed by PCR on DNA from venous blood leukocytes. In the total group, increased level of anxiety was detected in 60.7% and increased level of depression was detected in 31.3% of patients. Increased levels of anxiety and depression was associated with a polymorphism -238(G/A) TNF gene, i.e. hereditary factor, but not with the clinical characteristics of cancer (age, stage, grade of malignancy). Among -238(AG) carriers as compared to -238(GG) carriers there was significantly higher the number of women with severe depression (66.7% and 29.0%; p=0.03), as well as the mean score of HADS-D (8.9 ± 2.8 and 4.9 ± 3.6, respectively; p=0.0017). Thus, the risk group of patients prone to reactive depression was determined. These results indicate the necessity of psychological support of patients with breast cancer and correction of depressive states.