脑连接组学可提高乳腺癌患者 1 年生活质量下降的预测能力:一项多体素模式分析。

Brain connectomics improve prediction of 1-year decreased quality of life in breast cancer: A multi-voxel pattern analysis.

机构信息

Guangdong Academy of Population Development, Guangzhou, China.

Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

Eur J Oncol Nurs. 2024 Feb;68:102499. doi: 10.1016/j.ejon.2023.102499. Epub 2023 Dec 24.

Abstract

PURPOSE

Whether brain connectomics can predict 1-year decreased Quality of Life (QoL) in patients with breast cancer are unclear. A longitudinal study was utilized to explore their prediction abilities with a multi-center sample.

METHODS

232 breast cancer patients were consecutively enrolled and 214 completed the 1-year QoL assessment (92.2%). Resting state functional magnetic resonance imaging was collected before the treatment and a multivoxel pattern analysis (MVPA) was performed to differentiate whole-brain resting-state connectivity patterns. Net Reclassification Improvement (NRI) as well as Integrated Discrimination Improvement (IDI) were calculated to estimate the incremental value of brain connectomics over conventional risk factors.

RESULTS

Paracingulate Gyrus, Superior Frontal Gyrus and Frontal Pole were three significant brain areas. Brain connectomics yielded 7.8-17.2% of AUC improvement in predicting 1-year decreased QoL. The NRI and IDI ranged from 20.27 to 54.05%, 13.21-33.34% respectively.

CONCLUSION

Brain connectomics contribute to a more accurate prediction of 1-year decreased QoL in breast cancer. Significant brain areas in the prefrontal lobe could be used as potential intervention targets (i.e., Cognitive Behavioral Group Therapy) to improve long-term QoL outcomes in breast cancer.

摘要

目的

脑连接组学是否能预测乳腺癌患者 1 年后生活质量(QoL)下降尚不清楚。本研究采用一项多中心样本的纵向研究来探讨其预测能力。

方法

连续纳入 232 例乳腺癌患者,214 例患者完成了 1 年 QoL 评估(92.2%)。在治疗前采集静息态功能磁共振成像,采用多体素模式分析(MVPA)来区分全脑静息态连接模式。计算净重新分类改善(NRI)和综合判别改善(IDI),以评估脑连接组学相对于传统危险因素的增量价值。

结果

扣带回旁回、额上回和额极是三个显著的脑区。脑连接组学在预测 1 年后 QoL 下降方面的 AUC 改善为 7.8-17.2%。NRI 和 IDI 的范围分别为 20.27%-54.05%和 13.21%-33.34%。

结论

脑连接组学有助于更准确地预测乳腺癌患者 1 年后 QoL 下降。前额叶的显著脑区可作为潜在的干预靶点(如认知行为团体治疗),以改善乳腺癌患者的长期 QoL 结局。

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