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心理压力与肿瘤进展及抗肿瘤疗效的相关性
Correlation of psychological stress with tumor progression and efficacy of antitumor therapy
心理压力对人类日常生活和身心健康产生极大的负面影响。随着传统生物医学模式向生物⁃心理⁃社会医学模式转变，恶性肿瘤患者的心理状态日益受到关注。患者常因肿瘤进展、死亡恐惧、经济负担、癌痛及抗肿瘤治疗不良反应而面临巨大的心理压力。长期心理压力造成的慢性应激会通过神经内分泌和交感神经系统引起相关激素和神经递质的释放及特定受体的激活，进而加速肿瘤进展，包括促进肿瘤增殖和转移，诱发炎症反应，引起肠道菌群失调，导致昼夜节律及代谢紊乱以及影响基因组的稳定性等；同时通过抑制肿瘤免疫及诱导耐药对抗肿瘤疗效产生负性影响。本文对心理压力与肿瘤进展和抗肿瘤疗效的相关性和潜在机制进行综述，以期为肿瘤患者心理压力的早期评估与干预以及肿瘤患者个体化治疗提供依据，为提高抗肿瘤治疗效果提供新思路。
Psychological stress significantly impacts human life and health. With the transition of the medical model from the traditional biomedical approach to the "bio-psycho-social" model， the psychological state of patients with malignant tumors is increasingly garnering attention. Patients with malignant tumors often face substantial psychological stress due to fears of tumor progression and mortality， financial burdens， cancer-related pain， and adverse effects from antineoplastic therapy. Chronic stress caused long-term psychological pressure can accelerate tumor progression through neuroendocrine pathways and the activation of the sympathetic nervous system， leading to the release of related hormones and neurotransmitters， activation of specific receptors， promotion of tumor proliferation and metastasis， induction of inflammatory responses， dysbiosis of gut microbiota， disruption of circadian rhythms and metabolism， as well as affecting genomic stability. Moreover， it negatively impacts the efficacy of antitumor therapy by suppressing tumor immunity and inducing drug resistance. This article systematically reviews the correlation and potential mechanisms between psychological stress and tumor progression， as well as the efficacy of antitumor therapy. It aims to provide a basis for the early assessment and intervention of psychological stress in cancer patients， as well as to offer insights into personalized treatment for cancer patients， thereby improving the efficacy of antitumor therapy.
心理压力 / 慢性应激 / 激素 / 肿瘤进展 / 抗肿瘤疗效
psychological stress / chronic stress / hormones / tumor progression / the efficacy of antitumor therapy
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