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World J Psychiatry. Oct 19, 2026; 16(10): 122042
Published online Oct 19, 2026. doi: 10.5498/wjp.122042
Determinants of psychological emotions in lung cancer patients and their correlations with tumor markers and inflammatory cytokines
Peng Wu, Jun Chen, Jie Ding, Feng Shi, Hua Wu, Jun Yang
Peng Wu, School of Medical Laboratory Technology, Xinyang Vocational and Technical College, Xinyang 464000, Henan Province, China
Jun Chen, Department of Pathology, Xinyang 154 Hospital, Xinyang 464000, Henan Province, China
Jie Ding, College Student Mental Health Education Center, Xinyang Vocational and Technical College, Xinyang 464000, Henan Province, China
Feng Shi, Department of Thoracic Surgery, Affiliated Hospital of Xinyang Vocational and Technical College, Xinyang 464000, Henan Province, China
Hua Wu, Department of Medical Oncology, Xinyang Central Hospital, Xinyang 464000, Henan Province, China
Jun Yang, Department of Orthopedics, Affiliated Hospital of Xinyang Vocational and Technical College, Xinyang 464000, Henan Province, China
Co-first authors: Peng Wu and Jun Chen.
Author contributions: Wu P wrote the manuscript, performed data analysis and interpretation; Wu P and Wu H provided the study materials; Wu P and Yang J collected and assembled the data; Chen J, Ding J, and Shi F conceptualized and designed the study; Yang J provided administrative support; Wu P and Chen J contributed equally to this manuscript and are co-first authors. All authors participated in manuscript writing and approved the final manuscript.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Supported by Henan Provincial Science and Technology Research Project, No. 242102310491; Henan Provincial Higher Education Key Scientific Research Project Plan, No. 25B320029; and Xinyang Municipal Science and Technology Research Project, No. 20250083.
Institutional review board statement: This study was approved by the Ethic Committee of Affiliated Hospital of Xinyang Vocational and Technical College (Approval No. 2024-01-18).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Peng Wu, Lecturer, School of Medical Laboratory Technology, Xinyang Vocational and Technical College, No. 48 24
th Street, Yangshan New District, Xinyang 464000, Henan Province, China.
victorwumed@163.com
Received: April 30, 2026
Revised: June 28, 2026
Accepted: July 28, 2026
Published online: October 19, 2026
Processing time: 163 Days and 1.3 Hours
BACKGROUND
Lung cancer patients experience significant psychological distress, yet the underlying determinants and their biological implications are not well understood. Chronic negative emotions may influence peripheral tumor markers (TMs) and inflammatory cytokines (ICKs) via neuroendocrine-immune pathways.
AIM
To investigate the determinants of psychological conditions in lung cancer patients and analyze their correlations with TMs and ICKs.
METHODS
A total of 128 advanced non-small cell lung cancer patients who received chemoradiotherapy between January 2023 and December 2025 participated in a questionnaire survey. Demographic and clinical data were collected using a basic data questionnaire, while depression and anxiety levels were assessed using the Self-Rating Depression Scale (SDS)/Self-Rating Anxiety Scale (SAS). Determinants associated with anxiety and depression were explored, and correlations between TMs, ICKs, and anxiety and depression scores were analyzed.
RESULTS
The cohort had mean scores of 48.84 ± 7.56 on the SAS and 50.20 ± 8.81 on the SDS, with anxiety observed in 43.7% and depressive symptoms in 39.8% of patients. Regression analysis indicated that age and a per capita monthly household income below 4000 yuan were risk factors for anxiety, while a university education or higher offered protective benefits. Divorced or widowed status, a per capita monthly household income below 4000 yuan, and solitary living were identified as risk factors for depression. Lung cancer patients with anxiety or depression exhibited statistically elevated levels of carcinoembryonic antigen, neuron-specific enolase, cytokeratin fragment antigen 21-1, interleukin-6, and tumor necrosis factor-α, compared to those without these emotional disturbances. In all patients, SAS and SDS scores showed positive correlations with carcinoembryonic antigen, neuron-specific enolase, cytokeratin fragment antigen 21-1, interleukin-6, and tumor necrosis factor-α levels.
CONCLUSION
A significant proportion of lung cancer patients experience anxiety and depression, with monthly household income serving as a related factor. Patients suffering from psychological distress show elevated serum levels of TMs and ICKs. Emphasis should be placed on the importance of social support for the physical and mental health of patients during clinical diagnosis and treatment.
Core Tip: This study assessed the prevalence of anxiety and depression, alongside associated psychosocial factors, in 128 patients with stage C advanced non-small cell lung cancer undergoing chemoradiotherapy. Additionally, it examined the cross-sectional relationships between these factors and serum tumor markers and pro-inflammatory cytokines. The findings demonstrate a significant correlation between psychological distress and socioeconomic factors; notably, elevated levels of emotional distress are linked to higher biomarker concentrations. This study highlights potential psychoneuroimmunological pathways involved in lung cancer progression and emphasizes the importance of integrating mental health screening into cancer treatment to enhance patients’ physical and mental well-being and improve biological outcomes.
