title: Anxiety and serum catecholamines as predictors of survival and recurrence in hepatocellular carcinoma.
abstract: Increasing evidence suggests that psychological factors are involved in tumor progression. This study investigated the influence of anxiety and serum catecholamines (CAs) on the prognosis of hepatocellular carcinoma (HCC).
  
  
  
  We enrolled 110 HCC patients who underwent tumor resection at the Affiliated Hospital of Nantong University, China, in this long-term investigation between 2005 and 2009. We evaluated anxiety using the Hamilton Anxiety Rating Scale (HAMA) and analyzed CA levels using an ELISA kit. We then assessed the association of each of them with overall survival (OS) and time to recurrence (TTR), as well as with other clinical variables.
  
  
  
  The HAMA scores significantly correlated with metastasis (P = 0.015), hepatitis B surface antigens (HBsAg) (P = 0.045), and the tumor-node-metastasis stage (P = 0.032), whereas the CA levels also significantly associated with tumor differentiation (P < 0.001). Univariate and multivariate analyses revealed that HAMA scores and CA levels were significant predictors of OS and TTR in HCC patients, with high levels of each being strongly correlated with poor prognosis.
  
  
  
  The HAMA scores and the CA levels were elevated in HCC patients and correlated with OS and TTR, suggesting that they are candidate prognostic markers of HCC.
authors.affiliation: Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People's Republic of China.
authors.forename: Jinxia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hepatic Oncology, Affiliated Cancer Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.
authors.forename: Guijuan
authors.initials: G
authors.lastname: Zong
authors.affiliation: Grade 14, Clinical Medicine Medical College, Nantong University, Nantong, Jiangsu Province, People's Republic of China.
authors.forename: Chengliang
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Hepatic Oncology, Affiliated Cancer Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.
authors.forename: Chunsun
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Hepatic Oncology, Affiliated Cancer Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Hepatic Oncology, Affiliated Cancer Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000523:psychology*; D002395:Catecholamines / Q000097:blood*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D002395:Catecholamines
keywords: anxiety; cancer; oncology; prognosis; serum catecholamine