Abstract: Objective To investigate the mediating role of self⁃representation in alexithymia and fear of disease progression in patients with nasopharyngeal carcinoma. Methods A total of 241 patients with nasopharyngeal carcinoma, who attended the Department of Medical Oncology of the First Affiliated Hospital of Guangxi Medical University from December 2020 to June 2021, were selected as the research objects. The distress disclosure index (DDI), the Toronto alexithymia scale (TAS) and the fear of progression questionnaire⁃short form (FoP⁃Q⁃SF) were used to analyze the correlation between the alexithymia, self⁃representation and the fear of disease progression in patients with nasopharyngeal carcinoma, and to analyze the mediating role of self⁃representation in alexithymia and fear of disease progression. Result The total scores of self⁃representation, fear of disease progression and alexithymia were (29.39±8.26) points, (34.51±5.68) points and (54.67±8.91) points, respectively, in patients with nasopharyngeal carcinoma. The results of Pearson correlation analysis showed that the total scores of alexithymia was negatively correlated with self⁃representation (P<0.001), and positively correlated with fear of disease progression (P<0.001). Self⁃representation was negatively correlated with fear of disease progression (P<0.001). The results of mediation analysis showed that there was a partial mediating effect of self⁃representation between alexithymia and fear of disease progression (the mediating effect accounted for 21.6%). Conclusions Patients with nasopharyngeal carcinoma are less willing to self⁃representation, and alexithymia and fear of disease progression need to be improved. Alexithymia can have an impact on patients' fear of disease progression through the mediation of self⁃representation.

Key words: Nasopharyngeal carcinoma, Alexithymia, Self?representation, Fear of disease progression, Mediating effect