非小细胞肺癌患者与健康对照组的脑皮层结构差异的回顾性研究

Differences in brain cortical structure between non-small cell lung cancer patients and healthy controls:a retrospective magnetic resonance imaging study

目的:分析非小细胞肺癌(non-small cell lung cancer,NSCLC)患者颅脑核磁共振影像学(magnetic resonance imaging,MRI)改变,并探讨其相关的影响因素,为患者的脑健康预防及保护提供依据。方法:选取2018年7月至2019年3月四川省肿瘤医院45例初诊为NSCLC(癌症组)及39例健康对照组(正常组)颅脑MRI数据,利用Freesurfer软件对MRI数据进行基于大脑皮层表面形态学测量(surface-based morphometry,SBM)分析,统计对比癌症组与正常组的脑区变化,利用偏相关分析方法将血常规、血脂、肿瘤标志物与变化脑区行相关性分析。结果:与正常组相比,癌症组右脑中央后回及顶叶上回脑皮质体积明显萎缩(P<0.05),但其厚度、表面积、曲率、脑沟深度未见明显变化(P>0.05)。此外,癌症组神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平明显高于正常组[(27.02±33.16)ng/mL vs.(7.8±3.85)ng/mL,P<0.05],相关性分析结果显示中央后回体积萎缩与NSE呈负相关(r=-0.268,P=0.039),血常规、血脂、癌胚抗原(carcinoembryonic antigen,CEA)与中央后回体积萎缩无明显相关性。结论:NSCLC可导致右脑中央后回及顶叶上回体积缩小,且中央后回体积缩小与NSE呈显著负相关,提示NSE可作为预测NSCLC相关脑损伤的潜在预测分子。

Objective: To analyze changes on brain magnetic resonance imaging(MRI) in patients with non-small cell lung cancer(NSCLC)and to determine the influencing factors to provide evidence for the prevention and maintenance of brain health in patients with cancer.Methods: Forty-five newly diagnosed patients with NSCLC(cancer group) and 39 healthy controls(control group) were enrolled at Sichuan Cancer Hospital & Institute from July 2018 to March 2019. MRI data were analyzed based on surface-based morphometry(SBM) of the cerebral cortex. Changes in brain regions were statistically compared between the two groups. Routine blood markers, blood lipid profiles,tumor markers, and changes in brain regions were analyzed using partial correlation analysis. Results: Regarding changes in cerebral cortex volume, the right posterior central gyrus and right superior parietal gyrus were significantly atrophied in the cancer group compared to that in the control group(P<0.05);however, the thickness, surface area, curvature, and sulcus depth were not significantly different(P>0.05).In addition, the level of neuron-specific enolase(NSE) in the cancer group was significantly higher than that in the control group [(27.02±33.16) ng/mL vs.(7.8±3.85) ng/mL, P<0.05]. Partial correlation analysis showed that the atrophy volume of the central posterior gyrus was negatively correlated with NSE levels(r=-0.268, P=0.039);However, the atrophy volume of the central posterior gyrus was not significantly correlated with routine blood markers, blood lipid profiles, and carcinoembryonic antigen(CEA) levels. Conclusions: Volumes of the posterior central gyrus and superior parietal gyrus of the right brain are atrophied in NSCLC patients, and volume reduction in the posterior central gyrus is significantly negatively correlated with NSE levels. These findings suggest that NSE can be used as a potential predictor of NSCLC-related brain damage.