EXPRESSION OF Β1- AND Β2-Adrenergic RECEPTORS IN ORAL SQUAMOUS CELL CARCINOMA AND THEIR ASSOCIATION WITH PSYCHOLOGICAL AND CLINICAL FACTORS

Background: Psychological stressors have been related to tumor progression through the activation of beta-adrenergic receptors (beta-AR) in several types of cancer. Purpose: This study aimed to investigate the expressions of beta(1)- and beta(2)-AR and their association with psychological and clinicopathological variables in patients with oral squamous cell carcinoma. Methods: Tumor samples from 99 patients diagnosed with OSCC were subjected to immunohistochemical reaction to detect the expression of beta(1)-AR and beta(2)-AR. Anxiety and depression symptoms were assessed using the Beck Anxiety Inventory and Beck Depression Inventory (BDI), respectively. The Brunel Mood Scale was used for measuring affective mood states. Results: Univariate analyzes revealed that higher expression of beta(1)-AR was associated with increased alcohol consumption (p = 0.032), higher education (p = 0.042), worse sleep quality (p = 0.044) and increased levels of pain related to the primary tumor (p < 0.001). Higher expression of beta(2)-AR was related with regional metastasis (p = 0.014), increased levels of pain related to the primary tumor (p = 0.044), anxiety (p < 0.001) and depressive (p = 0.010) symptoms and higher mood scores of angry (p = 0.010) and fatigue (p = 0.010). Multivariate analysis identified that patients with advanced clinical stage had lower beta(1)-AR expression (OR=0.145, 95% CI=0.025-0.828, p = 0.003). Higher anxiety symptoms and higher mood fatigue are independent factors for increased beta(2)-AR expression (OR=4256, 95% CI=1439-12606, p = 0.009; OR=3816, 95% CI=1258-11,573, p = 0.018, respectively). Conclusion: This study reveal that anxiety, fatigue symptoms, and clinical staging are associated with tumor expression of beta-adrenergic receptors in patients with oral cancer.