N末端B型脑利钠肽前体对乳腺癌蒽环类化疗相关心脏毒性的预测价值  

Predictive value of NT-proBNP in anthracycline-based chemotherapy-related cardiotoxicity of breast cancer

作　　者：龙惠东[1] 林云恩[4] 刘观成[2] 闫冰川[1] 梁傍顺[1] 廖志伟[3] 戴诗蕾 

机构地区：[1]广州医科大学附属肿瘤医院肿瘤科,广州510095 [2]广州医科大学附属肿瘤医院B超室,广州510095 [3]广州医科大学附属肿瘤医院放疗四科,广州510095 [4]广州医科大学附属肿瘤医院第一附属医院病理科,广州510095

出　　处：《中国医师杂志》2015年第10期1516-1519,共4页Journal of Chinese Physician

基　　金：基金项目：广州市中医药科技资助项目（20142A011024,20152A011023）

摘　　要：目的 探讨N末端B型脑利钠肽前体（NT-proBNP）在乳腺癌蒽环类化疗相关心脏毒性的诊断价值.方法 检测135例乳腺癌蒽环类化疗患者血浆NT-proBNP浓度,分析其化疗前后浓度变化与心脏毒性发生的关系,分析其诊断心脏毒性的浓度水平.结果 22例（16.29％）患者出现心脏毒性,心脏毒性组患者血浆中NT-proBNP水平显著高于无毒性组（P＜0.05）;根据ROC曲线,NT-proBNP诊断乳腺癌化疗后心脏毒性的曲线下面积为0.752（95％ CI：0.635 ～0.918）,综合考虑ROC曲线,设血浆NT-proBNP水平350 pg/ml为诊断心脏毒性的临界点,其诊断乳腺癌蒽环类相关心脏毒性的敏感度和特异度分别为70.32％、82.58％,阳性预测值为78.12％,阴性预测值为65.45％.结论 证实NT-proBNP在早期诊断乳腺癌蒽环类化疗后相关心脏毒性的应用价值,提示其可能成为较理想的心脏毒性预测标志物之一.Objective To explore the predictive value of serum N-terminal pro-brain natriuretic peptide （NT-proBNP） level in anthracycline-based chemotherapy-related cardiotoxicity of breast cancers.Methods A total of 135 breast cancer patients was analyzed if NT-proBNP was associated with chemotherapy-related cardiotoxicity.The level of NT-proBNP in the diagnosis of cardiotoxicity was assessed.Results A total of 22 patients （16.29%） had subsequent claims for cardiotoxicity events.NT-proBNP in cardiotoxicity group was significantly higher than that non-cardiotoxicity group （P 〈 0.05）.According to receiver operating characteristic （ROC） curve, the cut-off value of NT-proBNP was set at 350 pg/ml, specificity and sensitivity were 70.32% and 82.58% , respectively.Positive and negative predictive values were 78.12% and 65.45%, respectively.Conclusions The present study is to confirm excellent clinical value of NTproBNP on cardiotoxicity.The level of NT-proBNP for early detection of cardiotoxicity has good prospects for high risk patients.

关 键 词：利钠肽 脑/代谢 乳腺肿瘤/代谢/药物疗法 蒽环类/治疗应用/副作用 心脏/药物作用 

分 类 号：R737.9[医药卫生—肿瘤]