国际医学放射学杂志2024，Vol.47Issue(4)：383-389,7.DOI:10.19300/j.2024.L21473
乳腺癌病人新辅助化疗后脑白质高信号体积的早期变化
Early changes in white matter hyperintensities volume after neoadjuvant chemotherapy in breast cancer patients
摘要
Abstract
Objective To explore the longitudinal changes in white matter hyperintensities(WMH)volume after one cycle of neoadjuvant chemotherapy(NAC)in breast cancer patients.Method A total of 51 female breast cancer patients(NAC group)with an average age of(48.73±9.02)years old who planned to receive NAC were enrolled prospectively.At the same time,50 female healthy controls(HC group)were included,with an average age of(49.66±11.53)years old.Patients in the NAC group received brain MR scans and neuropsychological tests at baseline and after the first cycle of chemotherapy.They were divided into younger group(＜49 years old)and older group(≥49 years old)based their age.The HC group received the same assessment as the breast cancer patients at baseline.According to the distance between WMH and lateral ventricle,WMH was divided into juxtaventricular WMH,periventricular WMH,deep WMH,and juxtacortical WMH.The comparison of WMH volume and neuropsychological test scores between the two groups at baseline was performed using the Mann-Whitney U test.The Wilcoxon signed-rank test was used to compare the longitudinal changes in WMH volume and neuropsychological tests scores before and after chemotherapy in the NAC group,older group,and younger group.For the brain regions with statistically significant differences in WMH volume before and after chemotherapy in the NAC group,Spearman correlation analysis was used to analyze the correlation between changes in WMH volume and changes in neuropsychological tests scores.Results There was no significant difference in WMH volume and neuropsychological tests scores between NAC group and HC group at baseline(all P＞0.05).After chemotherapy,the FACT-Cog,PCA,and PCI scores in the NAC group were lower than those at baseline(all P＜0.05).The volume of juxtaventricular WMH,periventricular WMH,deep WMH,and total WMH in all NAC patients and older group after chemotherapy increased compared with baseline(all P＜0.05).In the younger group,there was no significant difference in the volume of WMH in each brain region after chemotherapy compared with baseline(all P＞0.05).In the NAC group,the change in the volume of periventricular WMH after chemotherapy was positively correlated with the change in time taken for the Trail Making Test Part A(TMT-A)(ρ=0.446,P=0.001).Conclusions The volume of juxtaventricular WMH,periventricular WMH,deep WMH,and total WMH volume increase significantly in breast cancer patients after chemotherapy.The increase in periventricular WMH volume may be related to a decrease in executive function.Additionally,chemotherapy has a greater effect on the volume of WMH in patients over 49 years old.关键词
脑白质高信号/磁共振成像/乳腺癌/新辅助化疗Key words
White matter hyperintensities/Magnetic resonance imaging/Breast cancer/Neoadjuvant chemotherapy分类
医药卫生引用本文复制引用
胡译心,周小榆,张久权,张菁,杨静,陈娇,刘代洪,辛恩慧..乳腺癌病人新辅助化疗后脑白质高信号体积的早期变化[J].国际医学放射学杂志,2024,47(4):383-389,7.基金项目
国家自然科学基金面上项目(82071883,82371937) （82071883,82371937）
重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX0951,CSTB2022NSCQ-MSX0823,cstc2021jcyj-msxmX0313,CSTB2024NSCQ-MSX0236) （CSTB2022NSCQ-MSX0951,CSTB2022NSCQ-MSX0823,cstc2021jcyj-msxmX0313,CSTB2024NSCQ-MSX0236）
重庆市沙坪坝区技术创新与应用发展项目(202389) （202389）
