Clinical characteristics of malignant pleural effusion and its relationship with cancer-related fatigue,psychological stress and exercise in the elderly with advanced lung cancer

Qu Shuangshuang; Zheng Limei; Li Jiangwei; Wang Ziqi; Yang Le; Wang Qun; Ji Xiaoqing; Pan Yuan

doi:10.11986/j.issn.1673-873X.2024.12.15

Abstract：Objective To explore the clinical characteristics of malignant pleural effusion and its relationship with cancer-re-lated fatigue,psychological stress and exercise in the elderly with advanced lung cancer.Methods A total of 180 elderly pa-tients with advanced lung cancer were enrolled.According to presence or absence of pleural effusion,they were divided into observation group(90 cases,effusion)and control group(90 cases,no effusion).All patients underwent chest CT examina-tion.The basic data in the two groups were compared.The clinical characteristics of malignant pleural effusion,cancer-re-lated fatigue(Revised Piper Fatigue Scale),psychological stress[Self-rating Anxiety Scale(SAS)]and exercise were ob-served.The influencing factors of malignant pleural effusion were analyzed by Logistic analysis.According to the amount of malignant pleural effusion,patients in observation group were divided into small amount group,medium amount group and large amount group,cancer-related fatigue,psychological stress and exercise in the three groups were analyzed.Results In the 90 elderly patients with advanced lung cancer,main histological type and effusion type were squamous cell carcinoma(38.89%)and exudative type(100.00%),proportions of vascular endothelial growth factor(VEGF)and carcinoembryonic antigen(CEA)in pleural effusion were both≥twice of the normal values were 76.67%and 81.11%,respectively.The scores of cancer-related fatigue and SAS,and proportion of diabetes mellitus history in observation group were higher than those in control group(P<0.05).The results of multivariate Logistic analysis showed that high scores of cancer-related fa-tigue and SAS,and diabetes mellitus were influencing factors of malignant pleural effusion(P<0.05).In small amount group,medium amount group and large amount group,scores of cancer-related fatigue and SAS were gradually increased(P<0.05).Conclusion Severe cancer-related fatigue,intense psychological stress and diabetes mellitus are risk factors of malignant pleural effusion in the elderly with advanced lung cancer.The pleural effusion volume is closely related to scores of cancer-related fatigue and SAS,but not related to exercise.