非小细胞肺癌患者大脑皮层变化及临床相关因素的初步研究  

A Preliminary Study of Cerebral Cortex Changes in NSCLC Patients and Its Related Clinical Factors

作　　者：吴川 陈功 董立 罗丽萍 高明权 吴自飞 方曾怡 王卫东 Wu Chuan;Chen Gong;Dong Li;Luo Liping;Gao Mingquan;Wu Zifei;Fang Zengyi;Wang Weidong(School of Medicine,University of Electronic Science and Technology of China,Chengdu 610054,Sichuan,China;College of Life Science and Technology,University of Electronic Science and Technology of China,Chengdu 6111731,Sichuan,China;Department of Oncology,the Affiliated Hospital of Southuvest Medical University,Luzhou 646000,Sichuan,China;Radiotherapy Center,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]电子科技大学医学院,成都610054 [2]电子科技大学生命科学与技术学院,成都611731 [3]西南医科大学附属医院肿瘤科,四川泸州646000 [4]四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学医学院放疗中心,放射肿瘤学四川省重点实验室,成都610041

出　　处：《肿瘤预防与治疗》2021年第11期1026-1034,共9页Journal of Cancer Control And Treatment

基　　金：国家科技部重点研发计划(编号:2017YFC0113904);四川省科技厅重点研发专项(编号:2017SZ0004)。

摘　　要：目的:探讨非小细胞肺癌(non-small cell lung cancer,NSCLC)患者颅脑MRI影像学改变,评估肺癌患者脑区结构变化,并研究其可能的影响因素。方法:回顾性收集四川省肿瘤医院NSCLC患者治疗前组45例[平均年龄(57.04±8.1)岁],治疗后组42例[平均年龄(59.93±10.1)岁],以及正常组39例[平均年龄(48.90±11.9)岁]颅脑MRI影像学数据,利用Freesurfer软件对结构MRI数据进行基于大脑皮层表面形态学测量(surface-based morphometry,SBM)分析,采用QDEC统计软件统计对比治疗后组、治疗前组、正常组的脑区变化。将NSCLC患者临床参数(血常规、血脂、肿瘤标志物等指标)与变化脑区行相关性分析。结果:1)脑区皮层厚度:治疗后组与治疗前组、正常组相比,治疗后组患者双侧中央前回、顶叶上回及额上回皮层增厚(P<0.05);2)脑区体积:与正常组对比,治疗前组患者中央后回及顶叶上回的体积缩小(P<0.05);治疗后组患者中央后回、中央前回及顶叶上回较治疗前组患者体积明显增加(P<0.05),但与正常组差异无统计学意义(P>0.05);3)偏相关分析:左侧岛回平均厚度与血小板数呈负相关(r=-0.25,P=0.022),其余变化脑区与临床参数未见明显偏相关结果。结论:癌症和癌症治疗可能影响NSCLC患者大脑皮层体积和厚度,部分变化脑区与血小板变化呈负相关。Objective:To explore the changes in brain magnetic resonance imaging(MRI)in patients with non-small cell lung cancer(NSCLC),evaluate the changes in brain structure of patients with lung cancer,and study its possible influencing factors.Methods:We retrospectively collected the brain MRI images of 45 patients with NSCLC(57.0±8.1 years old)before treatment,42 cases(59.9±10.1 years old)after treatment,and 39 healthy controls(48.9±11.9 years old)from Sichuan Cancer Hospital.Surface-based morphometry analysis was conducted to measure the structural MRI data by using the FreeSurfer software,and brain changes among three groups were compared by using the QDEC software.The correlation of brain changes of NSCLC patients to clinical parameters(complete blood count,blood lipid,tumor markers,etc.)was analyzed.Results:The cortices in bilateral anterior central gyrus,superior parietal gyrus and superior frontal gyrus in the post-treatment group were thicker than those in other two groups(P<0.05).Volumes of posterior central gyrus and su perior parietal gyrus in the pre-treatment group were smaller than those in the control group(P<0.05);volumes of posterior central gyrus,anterior central gyrus and superior parietal gyrus in the post-treatment group were larger than those in the pretreatment group(P<0.05),but the former were not significantly different from those in the control group(P>0.05).Partial correlation analysis showed that the average thickness of the left insular gyrus was negatively correlated to the number of platelets(r=-0.251,P=0.022);partial correlation between clinical parameters and changes in other brain regions was not significant.Conclusion:This retrospective study shows that cancer and its relevant treatments may affect the volume and thickness of cerebral cortex in NSCLC patients,and that some altered brain regions are negatively correlated to changes in platelets.

关 键 词：非小细胞肺癌 皮层厚度 皮层体积 FREESURFER 

分 类 号：R734.2[医药卫生—肿瘤]