不同组织学类型肺癌患者大脑静息葡萄糖代谢改变研究

The preliminary study of brain glucose metabolism changes in patients with lung cancer of different histological types

目的 探讨不同组织学类型肺癌患者大脑静息葡萄糖代谢改变特点.方法 回顾性分析100例未经治疗的原发性肺癌患者全身18F-FDG PET/CT检查资料.肺癌组织学类型均经穿刺或手术病理明确,根据不同组织学类型将患者分为腺癌（42例）、鳞癌（37例）、小细胞肺癌（21例）3组.将50名健康体检者作为对照,采用统计参数地形图分析软件分析每组患者PET脑代谢显像资料,采用两样本t检验比较3组患者脑代谢改变的差异.结果 3组患者脑PET显像均表现为区域性大脑静息葡萄糖代谢降低,主要分布在左侧额叶上中回及双侧颞叶上、中、下回,小细胞肺癌组还可见右侧顶下小叶及海马区受累.小细胞肺癌组低代谢脑区面积（体素数3848）大于腺癌组（体素数1436）（t=14.33,P＜0.05）和鳞癌组（体素数1397）（t=10.07,P＜0.05）,腺癌组与鳞癌组之间差异无统计学意义（t=0.764,P＞0.05）.结论 肺癌患者大脑静息葡萄糖代谢改变与其组织学类型有一定相关性.脑代谢降低区多涉及精神情感功能区,PET脑显像有望为肺癌患者出现的精神情感障碍症状提供客观的分子影像学依据和可能的评价指标.

Objective To investigate the changes of resting brain glucose metabolism in patients with lung cancer of different histological types.Methods One hundred patients with primary untreated lung cancer were divided into three groups[adenocarcinoma group （42 cases）,squamous cell carcinoma group （37 cases）and small-cell carcinoma group （21 cases）] based on histological types confirmed by biopsy or surgical pathology.Their whole body 18F-FDG PET/CT were retrospectively studied.The brain PET data of three groups were analyzed individually using statistical parametric mapping,with 50 healthy controls as comparison.Results The brain PET imaging in all of three lung cancer groups showed relative reduction in the regional cerebral resting glucose metabolism,and mainly distributed in left superior and middle frontal gyrus and the inferior,middle and superior frontal gyrus bilateral frontal lobe.Besides,the hypometabolic brain areas were also detected in the right inferior parietal lobule and hippocampal in the small cell carcinoma group.The total hypometabolic brain area in the small cell lung cancer group （voxel values 3848）was greater than those in the adenocarcinoma （voxel values 1436）（t=14.33,P＜0.05）and the squamous cell carcinoma groups （voxel values 1397）（t=10.07,P＜0.05） respectively,and there was no statistical difference with respect to the areas between the later two groups （t=0.764,P＞0.05）.Conclusions The resting brain glucose metabolic changes in lung cancer patients may be correlated to their histological types of lung cancer.The reduced metabolic regions in lung cancer patients involved in some functional regions related to the mood disorders.The brain metabolic changes hopefully provide molecular imaging basis and evaluation indicator for lung cancer patients with affective disorders.