非脑部恶性肿瘤患者抑郁情绪的PET初步研究

A preliminary PET study of depressive symptoms in non-brain malignant tumor patients

目的探讨非脑部恶性肿瘤患者的抑郁情绪和18氟-脱氧葡萄糖(18F-FDG)正电子发射体层摄影(PET)脑显像的特点及其相关性。方法根据年龄、性别构成配对,使用抑郁自评量表(SDS)、24项汉密顿抑郁量表(HAMD)分别对12例非脑部恶性肿瘤患者(肿瘤组)及10例正常体检者(对照组)进行心理评估,所有对象行脑18F-FDGPET显像,采用感兴趣区(ROI)方法对两组图像数据进行分析。结果肿瘤组SDS标准总分高于对照组(52.9±9.6vs42±8.9,P=0.012<0.05),肿瘤组阻滞类因子分高于对照组,HAMD总分及其它6类因子分两组间无明显差异(P均>0.05)。ROI分析显示肿瘤组较对照组双侧额叶下回、海马及左侧扣带回、左侧海马旁回的葡萄糖代谢有所下降(P均<0.05)。肿瘤组SDS标准总分与以上部分脑区局部脑葡萄糖代谢率存在负相关,对照组SDS标准总分与其脑葡萄糖代谢率无明显相关。结论恶性肿瘤患者存在一定程度的抑郁情绪,其脑18F-FDGPET显像提示存在额叶和边缘系统的局部脑葡萄糖代谢下降,两者可能存在一定相关性。

Objective: To investigate depressive emotion and brain 18F-fluorodeoxyglucose(FDG) Position emission tomography (PET) mapping in malignant tumor patients except brain tumor and the relationship between them. Methods: PET with 18F-FDG was performed on 12 variable malignant tumor patients except brain tumor (tumor group) and 10 healthy controls (control group). The malignant tumor patients and healthy controls were conducted by Self-Rating Depression Scale(SDS)and 24 questions of the Hamilton Rating Scale for Depression(HAMD). Results: (1) The standard total score of SDS of the malignant tumor patients was statistically higher than that of the healthy controls (52.9±9.6 vs 42±8.9 , P=0.012 < 0.05). The total score of HAMD between the two groups was not statistically different(12.5±3.7 vs 11.7± 3.3, P>0.05). Retardation factor score in HAMD of the malignant tumor patients was statistically higher than that of the healthy controls (P<0.05). Other 6 factor scores were not statistically different (P>0.05). (2) Region of interest (ROI) analysis: Compared with healthy controls, the malignant tumor patients demonstrated decreased regional cerebral glucose metabolism rate in bilateral inferior frontal lobe, hippocampus, left cingulate gyrus and parahippocampal gyrus (P<0.05). These results are in accordance with previous PET studies on major depression disorder. (3) The standard total score of SDS of cancer patients was negatively correlated to the regional cerebral glucose metabolism rate in these ROIs. But the SDS score was not correlated to the regional cerebral glucose metabolism rate in healthy controls. Conclusion: The results show that the malignant tumor patients have depressive emotion and hypometabolism in some brain regions. The abnormalities in brain metabolism in malignant tumor patients might be associated with their depressive emotion.