School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, 233030, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, 233004, China.
Sci Rep. 2019 Sep 25;9(1):13833. doi: 10.1038/s41598-019-50358-y.
Identifying prognostic factors by affordable tools is crucial for guiding gastric cancer (GC) treatments especially at earlier stages for timing interventions. The autonomic function that is clinically assessed by heart rate variability (HRV) is involved in tumorigenesis. This pilot study was aimed to examine whether nonlinear indices of HRV can be biomarkers of GC severity. Sixty-one newly-diagnosed GC patients were enrolled. Presurgical serum fibrinogen (FIB), carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA199) were examined. Resting electrocardiogram (ECG) of 5-min was collected prior to surgical treatments to enable the HRV analysis. Twelve nonlinear HRV indices covering the irregularity, complexity, asymmetry, and temporal correlation of heartbeat fluctuations were obtained. Increased short-range temporal correlations, decreased asymmetry, and increased irregularity of heartbeat fluctuations were associated with higher FIB level. Increased irregularity and decreased complexity were also associated with higher CEA level. These associations were independent of age, sex, BMI, alcohol consumption, history of diabetes, left ventricular ejection fraction, and anemia. The results support the hypothesis that perturbations in nonlinear dynamical patterns of HRV predict increased GC severity. Replication in larger samples as well as the examination of longitudinal associations of HRV nonlinear features with cancer prognosis/survival are warranted.
确定具有成本效益的工具的预后因素对于指导胃癌（GC）治疗至关重要，尤其是在早期阶段以进行干预。自主神经功能是通过心率变异性（HRV）进行临床评估的，它参与肿瘤的发生。本研究旨在探讨 HRV 的非线性指标是否可以作为 GC 严重程度的生物标志物。共纳入 61 例新诊断的 GC 患者。检测术前血清纤维蛋白原（FIB）、癌胚抗原（CEA）和糖类抗原 19-9（CA199）。在手术治疗前采集 5 分钟的静息心电图（ECG），以进行 HRV 分析。获得了 12 个非线性 HRV 指标，涵盖了心跳波动的不规则性、复杂性、不对称性和时间相关性。短程时间相关性增加、不对称性降低和心跳波动不规则性增加与 FIB 水平升高相关。不规则性增加和复杂性降低也与 CEA 水平升高相关。这些关联独立于年龄、性别、BMI、饮酒、糖尿病史、左心室射血分数和贫血。这些结果支持这样一种假设，即 HRV 非线性模式的波动可以预测 GC 严重程度的增加。有必要在更大的样本中进行复制，并检查 HRV 非线性特征与癌症预后/生存的纵向关联。
