δ-连环蛋白高表达状态对乳腺癌患者化疗后短期脑认知功能影响的静息态功能MRI研究  

Resting MRI study on the effect ofδ-catenin over expression on short-term brain cognitive function in breast cancer patients after chemotherapy

作　　者：薛明团 杜伟 曹家骏 宋段 张俊毅 苗延巍[1] XUE Mingtuan;DU Wei;CAO Jiajun;SONG Duan;ZHANG Junyi;MIAO Yanwei(Department of Radiology,First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;CT and MR Departments,Affiliated Hospital of Chifeng University,Chifeng 024000,China;Department of Pathology,Affiliated Hospital of Chifeng University,Chifeng 024000,China)

机构地区：[1]大连医科大学附属第一医院放射科,大连116011 [2]内蒙古赤峰学院附属医院CT、MR科,赤峰024000 [3]内蒙古赤峰学院附属医院病理科,赤峰024000

出　　处：《磁共振成像》2024年第2期56-62,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：内蒙古自治区高等学校科学科研项目(编号:NJZY22190);内蒙古自治区卫生健康委医疗卫生科技计划项目(编号:202202336)。

摘　　要：目的利用静息态功能MRI探讨δ-连环蛋白(catenin)不同表达状态的乳腺癌患者采用蒽环联合环磷酰胺(anthracyclines cyclophosphamide,AC)化疗方案2个周期后的脑认知功能改变。材料与方法前瞻性收集66例经病理证实乳腺癌并首次进行标准化化疗患者,根据组织血清δ-catenin水平,分为δ-catenin高表达组31例和低表达组35例,同时收集健康对照(healthy control,HC)组36例。所有受试者在化疗前及2个化疗周期后进行神经心理学评分并行脑静息态功能MRI、3D-T1加权成像,分析脑静息态功能MRI指标,包括低频振幅(amplitude of low frequency fluctuation,ALFF)值、分数低频振幅(fractional amplitude of low frequency fluctuation,fALFF)值、局部一致性(regional homogeneity,ReHo)值,并对患者化疗前后神经心理学评分以及脑静息态功能MRI指标进行对比分析。结果化疗前δ-catenin高表达组人表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)显著高于低表达组,差异有统计学意义(P<0.05)。乳腺癌患者化疗前后神经心理学评分显示,δ-catenin高表达组患者化疗后癌症治疗认知功能评估(Functional Assessment of Cancer Therapy-Cognitive,FACT-Cog)总分、感知认知能力(Perceived Cognitive Abilities,PCA)、简易智力状态检查评分(Mini Mental State Examination,MMSE)、蒙特利尔认知评估评分(Montreal Cognitive Assessment,MOCA)、数字符号转化测验(Digital Symbol Substitution Test,DSST)以及中文听觉词语学习测验(Auditory Verbal Learning Test,AVLT)、数字连线实验B(Line-B)评分较化疗前差异有统计学意义,而低表达组只有AVLT-长时记忆(AVLT-long)评分差异有统计学意义(P均<0.05)。与化疗前相比,化疗2周期后部分脑区ALFF及ReHo值改变差异有统计学意义(P<0.05)。δ-catenin低表达组患者化疗后右侧前扣带和旁扣带脑回ALFF值下降,而δ-catenin高表达组右侧小脑半球4-5区、双侧脑岛、左侧舌回化疗后ALFF值�Objective:In this study,resting state fMRI was used to investigate the changes of brain cognitive function after 2 cycles of anthracycline cyclophosphamide(AC)chemotherapy in breast cancer patients with different expression of δ-catenin.Materials and Methods:A total of 66 patients with breast cancer confirmed by pathology and received standardized chemotherapy for the first time were prospectively collected.According to the level of tissue serum δ-catenin,they were divided into δ-catenin high expression group(n=31),δ-catenin low expression group(n=35)and healthy control(HC)group(n=36).All subjects received neuropsychological score and brain resting state fMRI and 3D-T1 weighted imaging before and after 2 cycles of chemotherapy.The functional indexes of brain resting state,including amplitude of low frequency fluctuation(ALFF),fractional amplitude of low frequency fluctuation(fALFF)and regional homogeneity(ReHo),the neuropsychological scores and the MRI index of brain resting state function were compared and analyzed before and after chemotherapy.Results:The expression of human epidermal growth factor receptor 2(HER-2)in δ-catenin high expression group was significantly higher than that in low expression group(P<0.05).The neurological scores of breast cancer patients before and after chemotherapy showed that there were significant differences in Functional Assessment of Cancer Therapy-Cognitive(FACT-Cog)-SUM,Perceived Cognitive Abilities(PCA),Mini Mental State Examination(MMSE),Montreal Cognitive Assessment(MOCA),Digital Symbol Substitution Test(DSST)and Auditory Verbal Learning Test(AVLT),Line-B scores in δ-catenin high expression group,while only AVLT-long-term memory scores in low expression group had significant differences(P<0.05).Compared with those before chemotherapy,there were significant differences in ALFF and ReHo values in some brain regions(P<0.05).The ALFF values of right anterior cingulate and paracingulate gyrus in δ-catenin low expression group decreased after chemotherapy,while those in �

关 键 词：乳腺癌 δ-连环蛋白 化疗相关认知障碍 纵向研究 静息态脑功能 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学] R749.1[医药卫生—临床医学]