Relationship of inflammatory markers and pain in patients with head and neck cancer prior to anticancer therapy

Abstract

Pain is a common symptom in patients with cancer, including those with head and neck cancer (HNC). While studies suggest an association between chronic inflammation and pain, levels of inflammatory cytokines, such as C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), have not been correlated with pain in HNC patients who are not currently undergoing anticancer treatment. The purpose of this study was to examine the relationship between these inflammatory markers and perceived pain in HNC patients prior to anticancer therapy. The study group consisted of 127 HNC patients and 9 healthy controls. Pain was assessed using the Brief Pain Inventory (BPI), and serum levels of CRP and TNF-α were determined using the particle-enhanced turbidimetric immunoassay (PETIA) and ELISA techniques, respectively. Patients experiencing pain had significantly higher levels of CRP (P<0.01) and TNF-α (P<0.05) compared with controls and with patients reporting no pain. There were significantly positive associations between pain, CRP level, and tumor stage. This is the first study to report a positive association between perceived pain and CRP in HNC patients at the time of diagnosis. The current findings suggest important associations between pain and inflammatory processes in HNC patients, with potential implications for future treatment strategies.

Predicting pre‐ and postoperative pain of endodontic origin in a southern Brazilian subpopulation: an electronic database study

“…In addition, a relationship has been suggested between pain and inflammatory markers (Oliveira et al . ). Thus, inflammatory mediators such as proinflammatory cytokines and C‐reactive protein may modulate nociception and contribute to the amplification of pain (Watkins & Maier ).…”

“…Available evidence suggests that serum levels of inflammatory markers are increased in patients with atherosclerotic CVD and cardiometabolic disorders (Blake & Ridker 2002), as well as in patients with apical periodontitis (Gomes et al 2013). In addition, a relationship has been suggested between pain and inflammatory markers (Oliveira et al 2014a). Thus, inflammatory mediators such as proinflammatory cytokines and C-reactive protein may modulate nociception and contribute to the amplification of pain (Watkins & Maier 2002).…”

Evaluation of Serum C-Reactive Protein Levels in Oral Premalignancies and Malignancies: A Comparative Study

“…In the present study, serum CRP levels were elevated in patients with symptoms such as pain and burning sensation in groups II and III. Oliveira et al [20] conducted a study to determine the relationship between inflammatory markers and perceived pain in head and neck cancer (HNC) patients prior to anticancer therapy. Patients experiencing pain had significantly higher levels of CRP (P<0.01) and TNF-α (P<0.05) compared to the controls and asymptomatic patients, thus suggesting significant positive associations between pain and CRP levels [20].…”

Analgesic Effect of Chinese Herbal Formula Hua-Jian-Ba-Du Ointment on Visceral Pain in Mice Induced by Acetic Acid

“…25 Many inflammatory cytokines such as TNF-α and IL-6 are involved in the process of pain. 26,27 To further elucidate the inflammatory mechanism of HJBDO at different intervention doses, proinflammatory cytokines and anti-inflammatory cytokines in the serum and peritoneal fluid were examined. It was observed that secretion of proinflammatory cytokines TNFα, IL-6, and PEG 2 increased above basal levels, whereas the anti-inflammatory cytokine IL-2 was restricted to different degrees in response to acetic acid damage.…”