Limbic Brain Hypometabolism in Patients Having Cancer : A PET Study

恶性肿瘤患者由于疾病的破坏性和积极的治疗方法，很容易发展为严重的心身创伤。本研究旨在利用脑成像技术记录癌症患者的心理-精神异常。在输注[18 F]-氟脱氧葡萄糖作为示踪剂后，通过正电子发射断层扫描（PET）拍摄癌症和良性患者的脑图像。比较了癌症患者和良性疾病患者的成像结果。使用Friston等人（伦敦，英国）开发的统计参数映射技术（SPM 96）分析数据。我们的研究结果很好地说明了以下脑基底的成像结果。(1)癌症患者在大脑边缘结构中表现出局部代谢异常，在额叶皮层中也观察到显著的减少和明显的下降。(2)这种代谢下降显示出与治疗过程的一些显著相关性。在应用任何特定治疗之前首次入院时研究的患者中，其分布更广泛且更显著。随后，在完成化疗和/或放疗的治疗方案后，这些区域明显消退。然而，在那些癌症复发的患者中再次注意到类似的广泛代谢异常。(3)我们推测，这些异常与心理因素如抑郁和焦虑障碍密切相关，这也是后来通过询问标准心理问卷得到证实的。

Patients suffering from malignant disease are very prone to develop severe psychosomatic trauma due to the devastating nature of the ailment and aggressive treatment approach. Our study was aimed to document the psycho-psychiatric abnormalities developed in patients suffering from cancer using brain imaging technique. Brain images of cancer and benign patients were taken by positron emission tomography (PET) after infusion of [18F]-fluoro-deoxy-glucose as a tracer. The imaging results were compared between the cancer patients and the patients suffering a benign disease. The data were analyzed using statistical parametrical mapping technique (SPM96) developed by Friston et al (London, U.K.).Our results have well illustrated the following imaging findings in the brain substrates. (1) Cancer patients have shown regional metabolic abnormality in the limbic structures of the brain with a remarkable decrement and noticeable decline was observed also in the frontal cortex. (2) This metabolic decline has shown some noted correlation with the course of treatments. It was more widely and significantly distributed in patients studied at their initial admission to a hospital prior to application of any specific treatment. Subsequently, the regions were regressed markedly after the completion of the therapeutic regimen of chemotherapy and/or radiation therapy. However, similar extensive metabolic abnormalities were again noted in those patients in whom the cancer had recurred. (3) We have speculated that these abnormalities were strongly associated with psychological factors such as depressive and anxiety disorders which also was later confirmed by asking a standard psychological questionnaire.