白蛋白与碱性磷酸酶比值在乳腺癌术后蒽环类化疗药物心脏毒性评估中的临床意义  

Clinical Significance of Albumin-to-Alkaline Phosphatase Ratio in Evaluating the Cardiotoxicity of Anthracycline Chemotherapeutic Drugs after Breast Cancer Surgery

作　　者：李立云 何文博[1] 郝颖新 李姝墨 LI Liyun;HE Wenbo;HAO Yingxin;LI Shumo(Department of Breast Surgery,Dingzhou People's Hospital,Dingzhou,Hebei 073000,China;Department of Breast Surgery,the First Affiliated Hospital of Kunming University,Kunming 650031,China)

机构地区：[1]定州市人民医院乳腺外科,河北定州073000 [2]昆明大学第一附属医院乳腺外科,昆明650031

出　　处：《临床误诊误治》2023年第3期50-53,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会(20191749)。

摘　　要：目的 探讨白蛋白与碱性磷酸酶比值(AAPR)评估乳腺癌术后蒽环类化疗药物心脏毒性的价值。方法 将2018年6月—2021年6月收治的乳腺癌术后接受蒽环类化疗药物治疗的200例作为研究对象,根据患者化疗后是否发生心脏毒性事件分为心脏毒性组(n=56)和非心脏毒性组(n=144)。比较2组AAPR水平。经受试者工作特征(ROC)曲线评估AAPR对乳腺癌术后蒽环类化疗药物心脏毒性的诊断价值,采用多因素Logistic回归分析影响乳腺癌术后蒽环类化疗药物心脏毒性发生的相关因素。结果 心脏毒性组血清AAPR水平低于无心脏毒性组(P<0.01)。ROC曲线显示,AAPR诊断乳腺癌术后蒽环类化疗药物心脏毒性的曲线下面积为0.821,最佳截断值为0.48,敏感度、特异度分别为82.14%、60.41%。多因素Logistic回归分析显示,化疗持续时间、AAPR、肌钙蛋白T、脑钠肽、肌酸激酶、心肌型肌酸激酶同工酶均是影响乳腺癌术后蒽环类化疗药物心脏毒性发生的危险因素(P<0.01)。结论 乳腺癌术后蒽环类化疗药物致心脏毒性患者血清AAPR水平呈降低趋势,低水平的AAPR可作为预测乳腺癌术后蒽环类化疗药物心脏毒性发生的监测指标。Objective To explore the value of albumin-to-alkaline phosphatase ratio(AAPR)in evaluating the cardiotoxicity of Anthracycline chemotherapeutic drugs after breast cancer surgery.Methods From June 2018 to June 2021,200 patients who received Anthracycline chemotherapy drugs after breast cancer surgery in our hospital were taken as the research subjects.According to presence of cardiotoxicity events after chemotherapy,they were divided into cardiotoxicity group(n=56)and non-cardiotoxicity group(n=144).The levels of AAPR in the two groups were compared.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of AAPR ratio for the cardiotoxicity of Anthracycline chemotherapy drugs after breast cancer surgery.Multivariate Logistic regression analyses were used to analyze the related factors affecting the cardiotoxicity of Anthracycline chemotherapy drugs after breast cancer surgery.Results The level of serum AAPR in cardiotoxicity group was significantly lower than that in non-cardiotoxicity group(P<0.01).ROC curve showed that the area under the ROC curve(AUC)of AAPR ratio for diagnosing the cardiotoxicity of Anthracycline chemotherapy drugs after breast cancer surgery was 0.821,the cut-off value was 0.48,and the sensitivity and specificity were 82.14%and 60.41%,respectively.Multivariate Logistic regression analysis showed that duration of chemotherapy,AAPR,troponin T,brain natriuretic peptide,creatine kinase and myocardial creatine kinase isoenzyme were risk factors for cardiotoxicity of Anthracycline chemotherapy drugs after breast cancer surgery(P<0.01).Conclusion The level of serum AAPR in patients with cardiotoxicity of Anthracycline chemotherapy drugs after breast cancer surgery showed a downward trend,and the low level of AAPR could be used as a monitoring indicator to predict the occurrence of cardiotoxicity of Anthracycline chemotherapy drugs after breast cancer surgery.

关 键 词：乳腺肿瘤 白蛋白与碱性磷酸酶比值 蒽环类 心脏毒性 肌钙蛋白T 肌酸激酶 

分 类 号：R737.9[医药卫生—肿瘤]