Department of Radiology, School of Medicine, Chongqing University Cancer Hospital, Chongqing University, Chongqing, 400030, People's Republic of China.
Department of Critical Care Medicine, School of Medicine, Chongqing University Cancer Hospital, Chongqing University, Chongqing, 400030, People's Republic of China.
Clin Exp Metastasis. 2024 Dec;41(6):959-969. doi: 10.1007/s10585-024-10315-0. Epub 2024 Oct 1.
The distribution of brain metastases (BMs) in patients with lung cancer may be associated with the primary tumor-related factors and cerebral small vascular diseases (CSVDs). The aim of this study was to investigate the potential effects of the above factors on the distribution of BMs. A total of 5,788 lesions in 823 patients with BMs from lung cancer were enrolled. The numbers of BMs and CSVDs in 15 brain regions were determined. CSVDs include recent small subcortical infarcts (RSSIs), perivascular spaces, and lacunes of presumed vascular origin (LPVOs). We collected the number of CSVDs, and primary tumor-related factors (including clinical and imaging features) in lung cancer patients with BMs. Univariate and multivariate linear regression were utilized to analyze the potential influence of the above factors on the number of BMs in 15 brain regions. In addition, we performed subgroup analyses of all patients with adenocarcinoma (AD), female patients with AD, male patients with AD, and patients with small cell lung cancer. Univariate linear regression analyses showed that bone metastasis, adrenal metastasis, RSSIs, and LPVOs were associated with the number of BMs in over half of the examined brain regions. Only the independent association of LVPOs persisted in the multivariate linear regression analyses, and similar phenomenon was found in the subgroup analyses. In conclusion, the distribution of BMs in lung cancer patients appears to be associated with the presence of LVPOs, while primary tumor-related factors have less influence.
脑转移瘤（BMs）在肺癌患者中的分布可能与原发性肿瘤相关因素和脑小血管疾病（CSVDs）有关。本研究旨在探讨上述因素对 BMs 分布的潜在影响。共纳入 823 例肺癌脑转移患者的 5788 个病灶，确定了 15 个脑区的 BMs 和 CSVDs 数量。CSVDs 包括近期小皮质下梗死（RSSIs）、血管周围间隙和推测血管来源的腔隙（LPVOs）。我们收集了 CSVDs 的数量以及肺癌脑转移患者的原发性肿瘤相关因素（包括临床和影像学特征）。采用单因素和多因素线性回归分析上述因素对 15 个脑区 BMs 数量的潜在影响。此外，我们对所有腺癌（AD）患者、女性 AD 患者、男性 AD 患者和小细胞肺癌患者进行了亚组分析。单因素线性回归分析显示，骨转移、肾上腺转移、RSSIs 和 LPVOs 与半数以上检查脑区的 BMs 数量有关。仅 LVPOs 的独立相关性在多因素线性回归分析中持续存在，亚组分析也发现了类似的现象。总之，肺癌患者 BMs 的分布似乎与 LVPOs 的存在有关，而原发性肿瘤相关因素的影响较小。
