Brain metabolomic profiles of lung cancer patients prior to treatment characterized by proton magnetic resonance spectroscopy

International Journal of Clinical and Experimental Medicine

Ruth A Reinsel¹  William Moore¹  Douglas L Rothman¹  Helene Benveniste¹  Christoffer Johansen¹  Shaonan Zhang¹  Haifang Li¹  Thomas V Bilfinger¹  Mario Rebecchi¹  Hedok Lee¹ 

关键词: Lung cancer;    proton magnetic resonance spectroscopy;    brain;    glutamate;    proinflammatory cytokines;    fatigue;   

DOI  :  

学科分类：医学（综合）

来源: e-Century Publishing Corporation

【 摘 要 】

Cancer patients without evidence of brain metastases often exhibit constitutional symptoms, cognitive dysfunction and mood changes at the time of clinical diagnosis, i.e. prior to surgical and/or chemotherapy treatment. At present however, there is limited information on brain metabolic and functional status in patients with systemic cancers such as lung cancer prior to initiation of treatment. Therefore, a prospective, observational study was conducted on patients with a clinical diagnosis of lung cancer to assess the cerebral metabolic status before treatment using proton magnetic resonance spectroscopy (¹HMRS). Together with neurocognitive testing, ¹HMRS was performed in the parietal and occipital cortices of patients diagnosed with a lung mass (N=17) and an age-matched control group (N=15). Glutamate concentrations in the occipital cortex were found to be lower in the patients compared to controls and the concentrations of creatine and phosphocreatine were significantly lower in the parietal cortex of the patients. The lung cancer patients were also characterized by greater fatigue scores (but not depression) prior to treatment when compared to controls. In addition, the serum concentration of interleukin-6 (proinflammatory cytokine) was higher in patients compared to controls; and the concentration of tumor-necrosis factor alpha ([TNF-α]) was positively correlated to the metabolic activity of the lung tumor as defined by the 2-deoxy-2-(¹⁸F)fluoro-D-glucose (¹⁸FDG) positron emission tomography (PET) derived maximal standardized uptake values (SUV_max). Finally, multivariate statistical modeling revealed that the concentration of N-acetyl-aspartate [NAA] in the occipital cortex was negatively associated with [TNF-α]. In conclusion, our data demonstrate that the cerebral metabolic status of patients with lung cancer is changed even prior to treatment. In addition, the association between inflammatory cytokines, SUV_max and [NAA] points towards interactions between the cancer’s inherent metabolic activity, systemic subclinical inflammation and brain function.

【 授权许可】

Unknown