Higher plasma catecholamine concentrations in oral cancer patients and association with clinical and psychological characteristics.

INTRODUCTION

Cancer patients often experience increased activity of the Sympathetic Nervous System (SNS). A dysregulation in the stress-related catecholamines secretion, including norepinephrine (NE) and epinephrine (EPI), has been associated with tumor progression and worse clinical and psychological outcomes. However, the systemic secretion profile of NE and EPI and their predictors in patients with oral cancer have been poorly investigated.

PATIENTS AND

METHODS

The present study investigated the association of plasma NE and EPI levels in 168 patients with Oral Squamous Cell Carcinoma (OSCC) with demographic, clinicopathological, biobehavioral and psychological variables. Catecholamine levels in patients with oral cancer were compared to hormone levels in patients with oral leukoplakia and healthy individuals. Plasma NE and EPI levels were measured by High Performance Liquid Chromatography with Electrochemical Detection (HPLC-ED). Psychological mood states and emotional symptoms were assessed by the Brunel Mood Scale (BRUMS).

RESULTS

Systemic NE concentrations were significantly higher in patients with OSCC compared to patients with oral leukoplakia (p < 0.001) and healthy volunteers (p = 0.003). Patients with OSCC also displayed increased plasma EPI levels, but this result did not reach significance after adjusting for covariates (p = 0.098) and was influenced by the tobacco consumption (p = 0.018). Multivariate analyzes identified the mood descriptors "anger" and "alert" as predictive variables for increased NE plasma levels in OSCC patients (β = 0.260, SE = 0.117, .028 and β = 0.151, SE = 0.073, p = 0.004, respectively). No variable was associated with EPI plasma levels in OSCC patients.

CONCLUSION

The results reveal that patients with oral cancer display increased systemic concentrations of stress-related catecholamines, and that higher levels of norepinephrine are associated with the emotional symptoms of anger and alertness.