人類微小病毒B19感染對癌症患者之憂鬱與認知的相關性探討

研究顯示腫瘤微環境中的慢性發炎症狀與微生物感染引起的慢性疲勞、認知障礙間，存在著相互助長的關係。人類微小病毒B19 (B19V)的感染已知與許多癌症相關，但是B19V感染對於癌症患者憂鬱及認知的影響並不清楚。因此本論文針對乳癌及肺癌患者進行研究：乳癌收案對象共157名(未化療組83名、化療組34名、健康對照組40名)；肺癌收案對象共141名(未化療組73名、化療組29名、健康對照組39名)，分析人類微小病毒B19V感染對於癌症患者憂鬱及認知的相關性。結果發現(1)乳癌未化療組與健康對照組相比，焦慮及憂鬱分數顯著上升。乳癌化療組中具有B19V IgG抗體的患者，其憂鬱分數顯著上升，認知分數顯著下降。(2)肺癌未化療組與健康對照組相比，焦慮及憂鬱分數顯著上升。肺癌未化療組中具有B19V VP1u IgG抗體的患者，憂鬱及疲勞分數顯著下降，認知分數顯著上升。綜合以上結果，在乳癌化療組中，人類微小病毒B19V IgG抗體存在對於患者憂鬱及認知分數具有負面影響。然而，在肺癌未化療組中，人類微小病毒B19V VP1u IgG抗體存在則對於患者憂鬱及認知分數具有正向幫助。這是一項新的發現。因此，我們建議癌症患者在治療前後可進行血清中的B19V抗體檢測，除了瞭解B19V感染情形更有助於醫師評估患者憂鬱及認知的情況。

Studies have shown that chronic inflammation in the tumor microenvironment, chronic fatigue, and cognitive impairment caused by microbial infection has a mutually reinforcing relationship. Human parvovirus B19 (B19V) infection is known to be associated with many cancers, but the effect of B19V infection on depression and cognition of cancer patients is not clear. Therefore, this study focuses on breast cancer and lung cancer patients. A total of 157 breast cancer cases (83 in the non-chemotherapy group, 34 in the chemotherapy group, and 40 in the healthy control group); a total of 141 lung cancer cases (73 in the non-chemotherapy group), 29 in the chemotherapy group, and 39 in the healthy control group), to analyze the correlation of human parvovirus B19V infection on depression and cognition in cancer patients. The results showed that (1) Compared with the healthy control group, the scores of anxiety and depression of the breast cancer group without chemotherapy increased significantly. In the breast cancer chemotherapy group, patients with B19V IgG antibodies had a significant increase in depression score and a significant decrease in cognitive score. (2) Compared with the healthy control group, the scores of anxiety and depression in the lung cancer non-chemotherapy group increased significantly. In the lung cancer non-chemotherapy group, patients with B19V VP1u IgG antibody had a significant decrease in depression and fatigue scores, and a significant increase in cognitive scores. Based on the above results, in the breast cancer chemotherapy group, the presence of human parvovirus B19V IgG antibody harms patients' depression and cognitive scores. However, in the lung cancer non-chemotherapy group, the presence of human parvovirus B19V VP1u IgG antibody has a positive effect on depression and cognitive scores of patients. This is a discovery. Therefore, we recommend that cancer patients should be tested for B19V antibodies in the serum before and after treatment. In addition to understanding the B19V infection, it is more helpful for physicians to assess the depression and cognitive conditions of patients.