抑郁症在被诊断患有癌症的患者中非常普遍，并且也与预后不良有关。基于正念的干预在减轻患者的抑郁症状和改善生活质量方面是有效的。本次评估的目标是调查正念实践是否可以改善生存率，如果可以，哪些机制可能导致这些结果。虽然还没有进行长期研究来调查这个假设，但当前文献支持抑郁症的炎性基础，涉及促炎细胞因子和下丘脑-垂体-肾上腺轴功能障碍等贡献因素。许多抑郁症患者的炎症标志物，如白细胞介素6、肿瘤坏死因子α和皮质醇，都呈升高浓度。这些确切机制与癌症患者的高死亡率有关联。正念因其对细胞因子和皮质醇水平的影响而被研究，有有前途的数据支持此项干预可以显著降低炎症水平。因此，正念计划有可能影响这一人群的生存。关于正念对患癌抑郁和炎症标志物的长期影响还有限的数据，并且在将正念干预作为综合治疗计划的一部分中还存在潜在的障碍。因此，有必要通过纵向研究进一步探讨这些问题，以建立生存相关性。CA癌症杂志。2022;72：490-502。©2022作者。CA：由Wiley Periodicals LLC代表美国癌症协会出版的癌症杂志。

Depression is highly prevalent in those diagnosed with cancer and is also associated with poorer prognostic outcomes. Mindfulness-based interventions are effective in reducing depressive symptoms and improving quality of life in patients with cancer. The objective of this review was to investigate whether mindfulness practices can improve survival and, if so, what mechanisms of action may contribute to these outcomes. Although no long-term studies have investigated this hypothesis, the current literature supports an inflammatory basis for depression, implicating proinflammatory cytokines and hypothalamic-pituitary-adrenal axis dysfunction as contributing factors. Markers of inflammation, such as interleukin-6, tumor necrosis factor-α, and cortisol, are all found at elevated concentrations in many depressed individuals. These exact mechanisms are associated with higher mortality in patients with cancer. Mindfulness has been studied for its effects on cytokine and cortisol levels, and there are promising data to support that the intervention can measurably decrease inflammation. Therefore, it is conceivable that mindfulness programs can affect survival in this population. There are limited data on the long-term effects of mindfulness on depression and inflammatory markers in patients with cancer, and there are potential barriers to the implementation of mindfulness-based interventions as part of a comprehensive treatment plan. Therefore, it is necessary to further explore these questions through longitudinal studies to establish a survival correlation. CA Cancer J Clin. 2022;72:490-502.© 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.