Blaes Anne H, Mulrooney Daniel A, Vogel Rachel Isaksson, Solovey Anna, Hebbel Robert, Peterson Bruce A, Neglia Joseph P, Biewen Carter, Konety Suma H, Duprez Daniel A
Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
St Jude Children's Research Hospital, Memphis, TN, USA.
Vasc Health Risk Manag. 2018 Sep 10;14:205-211. doi: 10.2147/VHRM.S151847. eCollection 2018.
Testicular cancer survivors who have received platinum-based chemotherapy are at risk for premature cardiovascular disease. The etiology of this risk is not well understood. This pilot study explores the impact of platinum-based chemotherapy on endothelial function.
Testicular cancer survivors <30 years old at the time of diagnosis who received platinum-based chemotherapy between 2002 and 2012, as well as 17 similarly aged male controls, were identified. Consented subjects underwent vascular assessment using the HDI/PulseWave CR-2000 Cardiovascular Profiling System and the Endo-PAT2000 system. Biomarkers and functional test markers were compared among cases, controls, and a group of historical controls using two sided two-sampled -tests and Wilcoxon rank-sum tests.
Thirteen survivors with a median age of 30.2 years and body mass index of 27.3 were enrolled, along with 17 healthy controls with a median age of 27.1 years and body mass index of 24.8. Median time from chemotherapy was 4.7 (range: 0.8-14) years. There was no statistical difference in reactive hyperemia peripheral arterial tonometry ratio between cases and controls ( = 0.574). There was no statistical difference in small or large artery elasticity between cases and controls ( = 0.086) or between cases and historical controls ( = 0.729). There was also no statistical difference in the blood levels of circulating endothelial cells, von Willebrand factor, and vascular cell adhesion molecules. There was a trend toward increased metabolic syndrome in cases (15%) as compared to recruited controls (6%), though this difference was not statistically significant ( = 0.565).
Testicular cancer survivors have no clinically significant difference in endothelial function compared to controls 4 years after the completion of chemotherapy. Further research is needed to explore the secondary modifiable causes that may contribute to the risk of premature cardiovascular disease.
接受铂类化疗的睾丸癌幸存者有患心血管疾病的风险。这种风险的病因尚不完全清楚。这项初步研究探讨了铂类化疗对内皮功能的影响。
确定了2002年至2012年间接受铂类化疗、诊断时年龄小于30岁的睾丸癌幸存者，以及17名年龄相仿的男性对照者。同意参与的受试者使用HDI/PulseWave CR - 2000心血管分析系统和Endo - PAT2000系统进行血管评估。使用双侧双样本t检验和Wilcoxon秩和检验比较病例组、对照组和一组历史对照组之间的生物标志物和功能测试标志物。
招募了13名中位年龄为30.2岁、体重指数为27.3的幸存者，以及17名中位年龄为27.1岁、体重指数为24.8的健康对照者。化疗后的中位时间为4.7（范围：0.8 - 14）年。病例组和对照组之间反应性充血外周动脉张力测定比值无统计学差异（P = 0.574）。病例组和对照组之间（P = 0.086）或病例组和历史对照组之间（P = 0.729）的小动脉或大动脉弹性无统计学差异。循环内皮细胞、血管性血友病因子和血管细胞粘附分子的血液水平也无统计学差异。与招募的对照组（6%）相比，病例组（15%）代谢综合征有增加的趋势，尽管这种差异无统计学意义（P = 0.565）。
化疗结束4年后，睾丸癌幸存者与对照组相比，内皮功能无临床显著差异。需要进一步研究以探索可能导致过早发生心血管疾病风险的继发可改变原因。
