非小细胞肺癌中腺癌与非腺癌的脑转移位置分布研究  

Distribution of brain metastases from adenocarcinoma and non-adenocarcinoma among non-small cell lung cancer

作　　者：陈伟 杜锋磊 左国平[1] 陈开强[3] 单国平 Chen Wei;Du Fenglei;Zuo Guoping;Chen Kaiqiang;Shan Guoping(School of Nuclear Science and Technology,University of South China,Hengyang 421001,China;Radiation Physics Department of Cancer Hospital Affiliated to University of Chinese Academy of Sciences Zhejiang Cancer Hospital,Hangzhou 310022,China;Radiotherapy Center of Fujian Cancer Hospital,Fuzhou 350014,China)

机构地区：[1]南华大学核科学技术学院,衡阳421001 [2]中国科学院大学附属肿瘤医院浙江省肿瘤医院放射物理科,杭州310022 [3]福建省肿瘤医院放疗中心,福州350014

出　　处：《中华放射医学与防护杂志》2024年第9期758-763,共6页Chinese Journal of Radiological Medicine and Protection

基　　金：浙江省医药卫生项目(2021PY040);福建省科技计划项目(2023Y0059);福建省卫健委计划课题(2021CXB013)。

摘　　要：目的探讨腺癌与非腺癌脑转移的位置分布差异,为制定更优化的治疗方案提供参考。方法回顾性分析2020年1月至2023年7月共283例在浙江省肿瘤医院接受放疗的非小细胞肺癌患者的资料。其中腺癌患者191例,平均年龄62.04岁;非腺癌患者92例,平均年龄63.85岁。患者的CT图像及脑转移肿瘤区同步形变配准至标准模板,以获取标准脑模板中的脑转移分布区域。使用Dice系数分析两者相似性,并在SPM与Dpabi软件上分别对腺癌和非腺癌脑转移的分布进行双样本t检验以确保结果的一致性。对于脑转移灶数目(BMs)≥4的脑区,统计2 mm×2 mm×2 mm体素的数量。结果非腺癌倾向于侵犯小脑后叶、楔前叶、小脑前叶、楔叶、枕中回与颞中回,体素在对应脑区的分布个数分别为2577、2291、1947、1550、1200、600;腺癌脑转移更倾向于发生在顶下小叶、小脑后叶、中央额回、中央前回、颞中回、楔前叶,体素在对应脑区的分布个数分别为211、201、194、186、137、84。结论腺癌与非腺癌的脑转移空间分布存在差异,两种亚型均存在偏好于侵犯特定脑区的现象。Objective To explore the differences in the spatial distributions of brain metastases(BMs)from adenocarcinoma and non-adenocarcinoma among non-small cell lung cancer(NSCLS),aiming to provide a reference for developing optimal treatment protocols.Methods A retrospective analysis was performed on data from 283 patients with NSCLC who underwent radiotherapy at the Zhejiang Cancer Hospital from January 2020 to July 2023.These patients included 191 adenocarcinoma cases with an average age of 62.04 years and 92 non-adenocarcinoma cases with an average age of 63.85 years.CT images with detected BMs of these patients were synchronously deformed and registered into a standard brain template to determine the distribution of BMs in the template.The Dice coefficient was employed to analyze the similarity in the distribution of BMs from adenocarcinoma and non-adenocarcinoma,and two-sample t-test was performed respectively using SPM and Dpabi software to ensure the consistency of the result.For brain regions with the number of BMs greater than or equal to 4,the voxels with a size 2 mm×2 mm×2 mm were counted.Results Non-adenocarcinoma tended to invade the posterior lobe of the cerebellum,precuneus,anterior lobe of the cerebellum,cuneus,middle occipital gyrus,and middle temporal gyrus,with corresponding voxel counts of 2577,2291,1947,1550,1200,and 600,respectively.In contrast,adenocarcinoma was more commonly metastasized to the inferior parietal lobule,posterior lobe of the cerebellum,central frontal gyrus,precentral gyrus,middle temporal gyrus,and precuneus,with the corresponding voxel counts of 211,201,194,186,137,and 84,respectively.Conclusion Brain metastases exhibit different distributions between adenocarcinoma and non-adenocarcinoma,and both subtypes prefer to invade specific brain regions.

关 键 词：非小细胞肺癌 腺癌 非腺癌 脑转移 空间分布 

分 类 号：R734.2[医药卫生—肿瘤]