血清cTnI、TFF1检测在乳腺癌化疗相关心脏毒性预测中的价值  

The Value of Serum cTnI and TFF1 Detection in the Prediction of Breast Cancer Chemotherapy-related Cardiotoxicity

作　　者：独晓燕[1] 潘彬[1] 周星[2] 王志民[2] 王晓慧[3] 要慧萍 DU Xiao-yan;PAN Bin;ZHOU Xing;WANG Zhi-min;WANG Xiao-hui;YAO Hui-ping(Department of BreastⅠ,Gansu Maternal and Child Health Hospital,Lanzhou,Gansu,730050,China;Department of Radiology,Gansu Provincial People's Hospital,Lanzhou,Gansu,730000,China;Department of Obstetrics and Gynecology,First Affiliated Hospital of Lanzhou University,Lanzhou,Gansu,730000,China)

机构地区：[1]甘肃省妇幼保健院乳腺一科,甘肃兰州730050 [2]甘肃省人民医院放射科,甘肃兰州730000 [3]兰州大学第一附属医院妇产科,甘肃兰州730000

出　　处：《现代生物医学进展》2021年第24期4733-4736,4790,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81660803)。

摘　　要：目的:探讨血清心肌肌钙蛋白I(Cardiac,Troponin I,c Tn I)、三叶因子1(trefoil factor 1,TFF1)检测在乳腺癌化疗相关心脏毒性预测中的价值。方法:2018年2月到2021年2月选择在本院接受蒽环类药物化疗的乳腺癌患者122例作为研究对象,所有患者都给予蒽环类药物化疗,在化疗前检测血清c Tn I、TFF1含量,在化疗4个周期后观察心脏毒性反应发生情况并进行预测价值分析。结果:122例乳腺癌患者根据表阿霉素化疗累积剂量分为低剂量组(450-500 mg/m^(2))70例、中剂量组(501-550 mg/m^(2))30例、高剂量组(>550 mg/m^(2))22例;三组化疗前的血清c Tn I、TFF1含量对比差异无统计学意义(P>0.05)。低剂量组、中剂量组、高剂量组化疗后的心电图异常率分别为1.4%、13.3%和22.7%,对比差异有统计学意义(P<0.05)。在122例患者中,Pearson分析显示心电图异常与c Tn I、TFF1、化疗剂量都存在相关性(P<0.05)。受试者工作特征(receiver operating characteristic,ROC)曲线显示c Tn I、TFF1预测心电图异常的曲线下面积分别为0.782、0.706。结论:乳腺癌患者使用蒽环类药物化疗存在一定的心脏毒性反应,且存在剂量依赖性,血清c Tn I、TFF1检测能有效预测化疗相关心脏毒性的发生,具有很好的临床应用价值。Objective:To investigate the value of serum cardiac troponin I(Cardiac,Troponin I,c Tn I)and trefoil factor 1(trefoil factor 1,TFF1)in the prediction of breast cancer chemotherapy-related cardiotoxicity.Methods:According to the cumulative dose of epirubicin chemotherapy,122 breast cancer patients were divided into low-dose group(450-500 mg/m^(2))70 cases,medium-dose group(501-550 mg/m^(2))30 cases,and high-dose group(>550 mg/m^(2))22 cases.The serum c Tn I and TFF1 levels were detected before chemotherapy,Observed the occurrence of cardiotoxicity and analyzed the predictive value after 4 cycles of chemotherapy.Results:122patients were divided into low-dose group of 70 cases,medium-dose group of 30 cases,and high-dose group of 22 cases accorded to the chemotherapy dose.There were no significant difference in the serum c Tn I and TFF1 levels compared among the three groups before chemotherapy(P>0.05).The abnormal rate of ECG after chemotherapy in the low-dose group,middle-dose group and high-dose group were 1.4%,13.3%and 22.7%,respectively,and compared the difference were statistically significant(P<0.05).In the 122 patients,Pearson analysis showed that ECG abnormalities were correlated with c Tn I,TFF1 and chemotherapy dose(P<0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve for c Tn I and TFF1 for predicting abnormal ECG were 0.782 and0.706,respectively.Conclusion:The use of anthracycline chemotherapy in breast cancer patients have certain cardiotoxicity and are dose-dependent.The detection of serum c Tn I and TFF1 can effectively predict the occurrence of chemotherapy-related cardiotoxicity and have good clinical application value.

关 键 词：乳腺癌 蒽环类药物 心脏毒性反应 心肌肌钙蛋白I 三叶因子1 预测价值 

分 类 号：R737.9[医药卫生—肿瘤]