Research Article Proinflammatory Cytokines Correlate with Depression and Anxiety in Colorectal Cancer Patients Diego Oliveira Miranda, 1 Taís Aparecida Soares de Lima, 2 Lucas Ribeiro Azevedo, 3 Omar Feres, 4 José Joaquim Ribeiro da Rocha, 4 and Gabriela Pereira-da-Silva 1,2,5 1 Postgraduate Program in Public Health Nursing, University of S˜ ao Paulo at Ribeir˜ ao Preto College of Nursing, 14040-902 Ribeir˜ ao Preto, SP, Brazil 2 University of S˜ ao Paulo at Ribeir˜ ao Preto College of Nursing, 14040-902 Ribeir˜ ao Preto, SP, Brazil 3 Postgraduate Program in Genetics, Department of Biology, Institute of Bioscience, Language & Literature and Exact Science, S˜ ao Paulo State University, 15054-010 S˜ ao Jos´ e do Rio Preto, SP, Brazil 4 Division of Coloproctology, Clinical Hospital, School of Medicine of Ribeir˜ ao Preto, University of S˜ ao Paulo, 14048-900 Ribeir˜ ao Preto, SP, Brazil 5 Department of Maternal-Infant Nursing and Public Health, University of S˜ ao Paulo at Ribeir˜ ao Preto College of Nursing, Avenida Bandeirantes 3900, 14040-902 Ribeir˜ ao Preto, SP, Brazil Correspondence should be addressed to Gabriela Pereira-da-Silva; gbisson@eerp.usp.br Received 20 June 2014; Revised 1 September 2014; Accepted 1 September 2014; Published 17 September 2014 Academic Editor: Pasquale F. Innominato Copyright © 2014 Diego Oliveira Miranda et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te objective of this study was to investigate whether serum cytokine levels correlate with depression and anxiety in colorectal cancer (CRC) patients. Twenty patients hospitalized for surgical resection of CRC were included in the study group and twenty healthy volunteers comprised the control group. Depression and anxiety were analyzed using the Hospital Anxiety and Depression Scale (HADS), and serum levels of IL-1, IL-6, IL-8, IL-10, IL-12, TNF-, and TGF- were measured by Cytometric Bead Array. We found that more than half of CRC patients presented clinically signifcant levels of anxiety or depression, and 65% of them manifested a combination of severe anxiety and depression. CRC patients had increased serum levels of IL-1, IL-6, IL-8, and TNF-  but lower IL-10 concentrations. Correlation analysis between HADS score and cytokine levels revealed a positive association of anxiety and/or depression with IL-1, IL-6, IL-8, and TNF- and a negative correlation with IL-10. Tese results indicate that circulating proinfammatory cytokines are involved in the pathophysiology of anxiety and depression in CRC patients. A better understanding of the molecular mechanisms involved in these psychological disorders will allow the design of therapeutic interventions that lead to an improved quality of life and overall survival of CRC patients. 1. Introduction Colorectal cancer (CRC) is the third most commonly diag- nosed cancer in males and the second in females, with over 1.3 million new cases and 694,000 deaths estimated to have occurred in 2012, according to the World Health Organization [1]. In Brazil, the National Cancer Institute estimated that, in 2014, approximately 17,000 women will be afected by CRC, surpassing for the frst time the number of cases of cervical cancer, trailing only breast tumors; 15,000 new cases are estimated among men, a number surpassed only by prostate and lung tumors [2]. Depression and anxiety are the most prevalent psycho- logical disorders in patients with cancer, including CRC [3], occurring in approximately 30–40% of these patients [4, 5]. Tese symptoms impair the adherence to cancer treatment and patients’ quality of life [6, 7]. Te identifcation and proper management of these disorders is an important issue in oncology practice [8]. Evidence supporting a role of cytokines, especially IL- 1, IL-6, IL-8, and TNF-, in the pathophysiology of depres- sion and anxiety, combined with the presence of high lev- els of these molecules in cancer patients, including CRC [9, 10], suggests that cytokines play a role in the etiology Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 739650, 5 pages http://dx.doi.org/10.1155/2014/739650