title: Symptom clusters of pain, depressed mood, and fatigue in lung cancer: assessing the role of cytokine genes.
abstract: OBJECTIVE
  Symptom clusters, the multiple, co-occurring symptoms experienced by cancer patients, are debilitating and affects quality of life. We assessed if a panel of immune-response genes may underlie the co-occurrence of severe pain, depressed mood, and fatigue and help identify patients with severe versus non-severe symptom clusters.
  
  
  METHODS
  Symptoms were assessed at presentation, prior to cancer treatment in 599 newly diagnosed lung cancer patients. We applied cluster analyses to determine the patients with severe versus non-severe symptom clusters of pain, depressed mood, and fatigue.
  
  
  RESULTS
  Two homogenous clusters were identified. One hundred sixteen patients (19 %) comprised the severe symptom cluster, reporting high intensity of pain, depressed mood, and fatigue and 183 (30 %) patients reported low intensity of these symptoms. Using Bayesian model averaging methodology, we found that of the 55 single nucleotide polymorphisms assessed, an additive effect of mutant alleles in endothelial nitric oxide synthase (-1474 T/A) (posterior probability of inclusion (PPI) = 0.78, odds ratio (OR) = 0.54, 95 % credible interval (CI) = (0.31, 0.93)); IL1B T-31C (PPI = 0.72, OR = 0.55, 95 % CI = (0.31, 0.97)); TNFR2 Met(196)Arg (PPI = 0.70, OR = 1.85, 95 % CI = (1.03, 3.36)); PTGS2 exon 10+837T > C (PPI = 0.69, OR = 0.54, 95 % CI = (0.28, 0.99)); and IL10RB Lys(47)Glu (PPI = 0.68; OR = 1.74; 95 % CI = (1.04, 2.92)) were predictive for symptom clusters.
  
  
  CONCLUSIONS
  Genetic polymorphisms may facilitate identification of high-risk patients and development of individualized symptom therapies.
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Unit 1468, 1155 Pressler Street, Houston, TX, 77030-4009, USA, creyes@mdanderson.org.
authors.forename: Cielito C
authors.initials: CC
authors.lastname: Reyes-Gibby
authors.forename: Michael D
authors.initials: MD
authors.lastname: Swartz
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Yu
authors.forename: Xifeng
authors.initials: X
authors.lastname: Wu
authors.forename: Sriram
authors.initials: S
authors.lastname: Yennurajalingam
authors.forename: Karen O
authors.initials: KO
authors.lastname: Anderson
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Spitz
authors.forename: Sanjay
authors.initials: S
authors.lastname: Shete
mesh_terms: D000368:Aged; D001499:Bayes Theorem; D016000:Cluster Analysis; D016207:Cytokines / Q000235:genetics* / Q000276:immunology; D003863:Depression / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology; D005221:Fatigue / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology; D020641:Polymorphism, Single Nucleotide; D018121:Receptors, Cytokine / Q000235:genetics* / Q000276:immunology; D012307:Risk Factors; D013577:Syndrome
chemical_list: D016207:Cytokines; D018121:Receptors, Cytokine