Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland.
Department of Oncology, Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland.
Radiat Oncol. 2019 Aug 30;14(1):155. doi: 10.1186/s13014-019-1366-1.
Transforming growth factor beta 1 (TGF-β1) and platelet-derived growth factor (PDGF) are cytokines involved in fibrotic processes causing radiotherapy (RT)-induced cardiovascular changes. We aimed to investigate the associations between TGF-β1 and PDGF and the echocardiographic changes that occur during RT and during three-year follow-up.
The study included 63 women receiving adjuvant RT for early-stage breast cancer or ductal carcinoma in situ. Serum TGF-β1 (ng/ml) and PDGF (ng/ml) levels were measured by enzyme-linked immunoassay and echocardiographic examination was performed before RT, after RT and at 3 years. Patients were grouped by biomarker behavior by a trajectory analysis.
TGF-β1 decreased from 19.2 (IQR 17.1-22.3) before RT to 18.8 (14.5-22.0) after RT (p = 0.003) and the decrease persisted at 17.2 (13.7-21.2) 3 years after RT (p = 0.101). PDGF decreased from 15.4 (12.6-19.1) before RT to 13.8 (11.7-16.2) after RT, p = 0.001, and persisted at 15.6 (10.4-18.4) at 3 years, p = 0.661. The TGF-β1 level before RT (Spearman's rho 0.441, p < 0.001) and the three-year change in TGF-β1 (rho = - 0.302, p = 0.018) correlated with global longitudinal strain (GLS) in echocardiography at 3 years. In trajectory analysis, two TGF-β1 behavior groups were found. Group 1 had significantly higher TGF-β1 levels before RT, 25.6 (22.3-28.6), than group 2, 17.8 (15.9-19.9), p < 0.001. In multivariable analysis, TGF-β1 trajectory group 1 (β = 0.27, p = 0.013), left-sided breast cancer (β = 0.39, p = 0.001) and the use of aromatase inhibitors (β = 0.29, p = 0.011) were significantly associated with a worsening in GLS from before RT to 3 years.
An elevated pretreatment TGF-β1 may predict RT-associated changes in echocardiography.
转化生长因子β 1（TGF-β1）和血小板衍生生长因子（PDGF）是参与纤维化过程的细胞因子，可导致放疗（RT）引起的心血管变化。我们旨在研究 TGF-β1 和 PDGF 与 RT 期间和三年随访期间发生的超声心动图变化之间的关系。
该研究纳入了 63 名接受早期乳腺癌或导管原位癌辅助 RT 的女性。通过酶联免疫吸附试验测量血清 TGF-β1（ng/ml）和 PDGF（ng/ml）水平，并在 RT 前、RT 后和 3 年后进行超声心动图检查。通过轨迹分析按生物标志物行为对患者进行分组。
TGF-β1 从 RT 前的 19.2（IQR 17.1-22.3）降至 RT 后的 18.8（14.5-22.0）（p=0.003），并且在 RT 后 3 年时仍保持下降趋势（p=0.101）。PDGF 从 RT 前的 15.4（12.6-19.1）降至 RT 后的 13.8（11.7-16.2）（p=0.001），并在 3 年时持续降至 15.6（10.4-18.4）（p=0.661）。RT 前的 TGF-β1 水平（Spearman 的 rho 0.441，p<0.001）和 TGF-β1 的 3 年变化（rho=-0.302，p=0.018）与 3 年后的超声心动图的整体纵向应变（GLS）相关。在轨迹分析中，发现了两个 TGF-β1 行为组。组 1 的 TGF-β1 水平明显高于组 2，组 1 的 RT 前 TGF-β1 水平为 25.6（22.3-28.6），组 2 的 TGF-β1 水平为 17.8（15.9-19.9）（p<0.001）。在多变量分析中，TGF-β1 轨迹组 1（β=0.27，p=0.013）、左侧乳腺癌（β=0.39，p=0.001）和使用芳香酶抑制剂（β=0.29，p=0.011）与从 RT 前到 3 年 GLS 的恶化显著相关。
升高的预处理 TGF-β1 可能预测与 RT 相关的超声心动图变化。
