血清Adropin、PTX-3、hs-CRP、TGF-β1水平在乳腺癌放化疗相关心脏毒性早期预测中的应用价值  

Application value of serum Adropin,PTX-3,hs-CRP and TGF-β1 in the early prediction of breast cancer chemoradiotherapy-related cardiotoxicity

作　　者：郑国红[1] 杨海芳[1] 曹钢[1] 王晓红[1] 肖磊[1] ZHENG Guo-hong;YANG Hai-fang;CAO Gang;WANG Xiao-hong;XIAO Lei(Department of Medical Oncology,Tangshan People s Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]唐山市人民医院肿瘤内科,河北唐山063000

出　　处：《川北医学院学报》2021年第11期1458-1462,共5页Journal of North Sichuan Medical College

基　　金：河北省卫生和计划生育委员会科研基金项目(20190169)。

摘　　要：目的:探讨血清Adropin、正五聚蛋白-3(PTX-3)、超敏C反应蛋白(hs-CRP)和转化生长因子-β1(TGF-β1)水平在乳腺癌放化疗相关心脏毒性早期预测中的应用价值。方法:选取120例左侧乳腺癌患者作为研究组,同期40例良性乳腺疾病患者作为对照组。根据放化疗后是否发生心脏毒性事件分为心脏毒性事件组(n=24)和非心脏毒性事件组(n=96)。检测各组血清Adropin、PTX-3、hs-CRP、TGF-β1表达水平,采用单因素分析及多因素Logistic回归分析乳腺癌放化疗发生相关心脏毒性事件的危险因素,绘制受试者工作特征曲线(ROC)分析上述指标对乳腺癌放化疗相关心脏毒性的早期预测价值。结果:研究组血清Adropin水平低于对照组,PTX-3、hs-CRP、TGF-β1水平均高于对照组(P<0.05);心脏毒性事件组血清Adropin水平低于非心脏毒性事件组,PTX-3、hs-CRP、TGF-β1水平均高于非心脏毒性事件组(P<0.05);心脏毒性事件的发生与年龄、高血脂、高血压等因素有关(P<0.05);Logistic回归分析显示,年龄(OR=1.919,P<0.001)、高血脂(OR=1.706,P<0.001)、高血压(OR=1.799,P=0.002)、糖尿病(OR=1.752,P=0.004)、Adropin(OR=2.239,P<0.001)、PTX-3(OR=2.085,P<0.001)、hs-CRP(OR=0.773,P=0.003)、TGF-β1(OR=2.361,P=0.007)、CK(OR=2.527,P=0.004)、CK-MB(OR=2.438,P=0.002)是影响乳腺癌放化疗患者发生相关心脏毒性事件的独立危险因素;ROC曲线发现血清Adropin、PTX-3、hs-CRP及TGF-β1联合预测乳腺癌放化疗患者发生相关心脏毒性事件的曲线下面积(AUC)为0.866,高于四者单独检测的0.724、0.691、0.712、0.733(P<0.05)。结论:乳腺癌放化疗相关心脏毒性患者血清Adropin水平呈降低趋势,PTX-3、hs-CRP和TGF-β1水平呈升高趋势,Adropin、PTX-3、hs-CRP及TGF-β1联合检测对乳腺癌放化疗相关心脏毒性具有一定的早期预测价值。Objective:To explore the application value of serum Adropin,pentraxin-3(PTX-3),high-sensitivity C-reactive protein(hs-CRP)and transforming growth factor-β1(TGF-β1)in the early prediction of breast cancer chemoradiotherapy-related cardiotoxicity.Methods:A total of 120 patients with left breast cancer were enrolled as study group.According to presence or absence of cardiotoxicity after chemoradiotherapy,they were divided into cardiotoxicity group(n=24)and non-cardiotoxicity group(n=96).And other 40 patients with benign breast diseases during the same period were enrolled as control group.The levels of serum Adropin,PTX-3,hs-CRP and TGF-β1 in different groups were detected and compared.The risk factors of cardiotoxicity were analyzed by univariate and multivariate Logistic regression analysis.The value of serum Adropin,PTX-3,hs-CRP and TGF-β1 levels in the early prediction of breast cancer chemoradiotherapy-related cardiotoxicity was analyzed by receiver operating characteristic(ROC)curves.Results:The level of serum Adropin in study group was lower than that in control group,while levels of PTX-3,hs-CRP and TGF-β1 were higher than those in control group(P<0.05).The level of serum Adropin in cardiotoxicity group was lower than that in non-cardiotoxicity group,while levels of PTX-3,hs-CRP and TGF-β1 were higher than those in non-cardiotoxicity group(P<0.05).The occurrence of cardiotoxicity was related to age,hyperlipidemia and hypertension(P<0.05).Logistic regression analysis showed that age(OR=1.919,P<0.001),hyperlipidemia(OR=1.706,P<0.001),hypertension(OR=1.799,P=0.002),diabetes mellitus(OR=1.752,P=0.004),Adropin(OR=2.239,P<0.001),PTX-3(OR=2.085,P<0.001),hs-CRP(OR=0.773,P=0.003),TGF-β1(OR=2.361,P=0.007),CK(OR=2.527,P=0.004)and CK-MB(OR=2.438,P=0.002)were independent risk factors of breast cancer chemoradiotherapy-related cardiotoxicity.ROC curve analysis showed that AUC of serum Adropin combined with PTX-3,hs-CRP and TGF-β1 for predicting cardiotoxicity was 0.866,greater than that of them alone(0.724,0.691,0

关 键 词：乳腺癌 放化疗 Adropin 正五聚蛋白-3 超敏C反应蛋白 转化生长因子-Β1 心脏毒性 

分 类 号：R737.9[医药卫生—肿瘤]