核素门控心肌灌注显像早期预测乳腺癌化疗后心脏毒性的临床价值  

Clinical value of radionuclide gated myocardial perfusion imaging in early prediction of cardiac toxicity after chemotherapy in breast cancer

作　　者：鹿存芝[1] 吴倩[1] 王亚楠[1] 鹿峰[1] 李向阳[2] LU Cun-zhi;WU Qian;WANG Ya-nan;LU Feng;LI Xiang-yang(Department of Nuclear Medicine,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China;Department of Radiotherapy,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China)

机构地区：[1]徐州市中心医院核医学科,江苏徐州221009 [2]徐州市中心医院放疗科,江苏徐州221009

出　　处：《川北医学院学报》2022年第12期1574-1578,共5页Journal of North Sichuan Medical College

基　　金：江苏省徐州市科学技术局重点研发项目(KC18194)。

摘　　要：目的:探讨核素门控心肌灌注显像(GMPI)对乳腺癌化疗患者心脏毒性的早期预测价值。方法:选取110例乳腺癌化疗患者(乳腺癌组)和60名健康女性体检者(对照组)作为研究对象。乳腺癌组患者于化疗前和化疗后进行常规超声心动图及GMPI检查,对照组于体检时完成常规超声心动图及GMPI检查;观察乳腺癌组化疗前后超声心动图及GMPI参数[相位直方图宽带(BW)、相位标准差(SD)、熵等]变化,采用受试者工作特征(ROC)曲线评价GMPI参数对乳腺癌化疗患者心脏毒性的预测价值。结果:乳腺癌组化疗前后常规超声心动图参数与对照组比较,差异无统计学意义(P>0.05)。化疗后,乳腺癌组BW、SD和熵均高于化疗前和对照组(P<0.05),高峰充盈率(PFR)、静息灌注总积分(SRS)、室壁运动异常积分(SMS)、室壁增厚异常积分(STS)与化疗前及对照组比较,差异无统计学意义(P>0.05)。根据随访1年,根据患者是否发生心脏毒性构建ROC曲线,BW预测的乳腺癌化疗后心脏毒性的ROC曲线下面积(AUC)为0.755,SD预测乳腺癌化疗后心脏毒性的AUC值为0.778,熵预测乳腺癌化疗后心脏毒性的AUC值为0.737。结论:GMPI相位分析获得的BW、SD、熵参数可作为乳腺癌化疗相关心脏毒性的早期预测指标,为临床防治提供参考。Objective:To investigate the early predictive value of radionuclide gated myocardial perfusion imaging(GMPI)for chemotherapy-induced cardiotoxicity in breast cancer patients.Methods:A total of 110 patients with breast cancer(breast cancer group)and 60 female healthy subjects(control group)were selected.Patients in breast cancer group underwent routine echocardiography and GMPI examination before and after chemotherapy,while patients in control group underwent routine echocardiography and GMPI examination during physical examination.The changes of echocardiography and GMPI parameters[phase bandwidth(BW),phase standard deviation(SD),entropy,et al]before and after chemotherapy in the breast cancer group were observed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of GMPI parameters on cardiac toxicity in breast cancer patients undergoing chemotherapy.Results:There was no significant difference in routine echocardiographic parameters between the breast cancer group and the control group before and after chemotherapy(P>0.05).Compared with before chemotherapy and control group,the BW,SD and entropy of breast cancer group after chemotherapy were significantly higher(P<0.05).There was no significant difference in peak filling rate(PFR),total resting perfusion score(SRS),ventricular wall motion abnormality score(SMS),and ventricular wall thickening abnormality score(STS)after chemotherapy compared with those before chemotherapy and the control group(P>0.05).The ROC curve was constructed according to whether the patients had cardiac toxicity at 1 year follow-up.The results showed that the AUC of BW for predicting cardiac toxicity after chemotherapy was 0.755,the AUC of SD for predicting cardiac toxicity after breast cancer chemotherapy was 0.778,the AUC of entropy prediction of cardiac toxicity after breast cancer chemotherapy was 0.737.Conclusion:BW,SD and entropy obtained by GMPI phase analysis can be used for early prediction of cardiac toxicity after chemotherapy in breast can

关 键 词：乳腺癌 化疗 蒽环类抗肿瘤药物 心脏毒性 门控心肌灌注显像 

分 类 号：R737.9[医药卫生—肿瘤] R730.41[医药卫生—临床医学]