目的:认知障碍在肺癌患者中很常见,影响其生活质量。对肺癌患者认知障碍的病因知之甚少。然而,肺癌患者认知功能障碍的相关因素尚未进行系统评价。本文就肺癌患者认知功能损害的相关因素进行综述。
方法:PubMed,EMBASE,PsycINFO,CINAHLPlus,和WebofScience检索了从数据开始到2024年1月21日发表的文章,重点关注与肺癌患者认知障碍相关的因素。关键评估是由两名审查员使用纽卡斯尔-渥太华量表独立进行的。
结果:共纳入17项观察性研究。结果显示,20个因素与认知障碍有关,包括心理因素(孤独,疲劳,焦虑,抑郁症,高症状负担,和基线认知障碍),生活方式和功能因素(每日步数,吸烟,和日常生活活动或日常生活障碍的工具活动),医疗因素(头颅照射,化疗,肺叶切除,术后谵妄,和药物治疗),和神经免疫因子(有神经元自身抗体,更改默认模式网络连接,谷氨酸和谷氨酸代谢失调,线粒体功能障碍,血脑屏障渗漏,和减少的T淋巴细胞)。
结论:这是第一个系统评价肺癌患者认知功能损害相关因素的研究,包括心理学,生活方式和功能,医疗,和神经免疫因素。这些发现可以帮助临床医生识别有风险的患者,并制定基于证据的干预措施,以预防肺癌患者的认知障碍。
OBJECTIVE: Cognitive impairment is common in lung cancer patients and impacts their quality of life. Little is known about the etiology of cognitive impairment in lung cancer patients. However, the associated factors of cognitive impairment among lung cancer patients have not been systematically reviewed. This
review aimed to summarize the factors related to cognitive impairment among lung cancer patients.
METHODS: PubMed, EMBASE, PsycINFO, CINAHL Plus, and Web of Science were searched to retrieve articles published from data inception until January 21, 2024, focusing on factors associated with cognitive impairment among lung cancer patients. Critical appraisal was undertaken by two reviewers independently using the Newcastle-Ottawa Scale.
RESULTS: A total of 17 observational studies were included. The results showed that 20 factors are associated with cognitive impairment, including psychological factors (loneliness, fatigue, anxiety, depression, high symptom burden, and baseline cognitive impairment), lifestyle and functional factors (daily step counts, smoking, and activities of daily living or instrumental activities of daily living impairments), medical treatment factors (cranial irradiation, chemotherapy, lobar resection, postoperative delirium, and on medication), and neuroimmunological factors (have neuronal autoantibodies, altered Default Mode Network connectivity, dysregulation in glutamate and glutamate metabolism, mitochondrial dysfunction, blood-brain barrier leakage, and reduced T-lymphocytes).
CONCLUSIONS: This is the first study to systematically
review 20 factors associated with cognitive impairment among lung cancer patients, encompassing psychology, lifestyle and functional, medical treatment, and neuroimmunological factors. These findings can help clinicians identify at-risk patients and develop evidence-based interventions to prevent cognitive impairment among lung cancer patients.