The Key Laboratory of Cardiovascular Remodeling and Function Research of Chinese Ministry of Education and Chinese Ministry of Health, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Chin Med Sci J. 2021 Dec 31;36(4):333-341. doi: 10.24920/003790.
Rapid development of anticancer treatments in recent years has greatly improved prognosis of cancer patients. However, with extension of survival time of cancer patients, various short-term and long-term side effects brought about by anticancer treatments, especially cardiotoxicity, have become increasingly prominent. Nonetheless, at present, there is few diagnostic methods with extremely high sensitivity and specificity to detect and accurately predict whether patients with anticancer treatment will experience cardiovascular complications. Inflammation, fibrosis and oxidative stress are considered to be important mechanisms involved in cardiotoxicity anticancer treatments. The cardiovascular biomarkers having the ability to predict and detect cardiovascular dysfunction earlier than clinical symptoms as well as left ventricular ejection fraction monitored by echocardiography, are of great value to timely treatment adjustment and prognosis evaluation. Cardiac troponin T/I and brain natriuretic peptide/N-terminal prohormone of brain natriuretic peptide have been routinely used in clinical practice to monitor cardiotoxicity, and some new biomarkers such as soluble suppression of tumorigenecity-2, myeloperoxidase, growth differentiation factor-15, galectin-3, endothelin-1, have potential in this area. In the future, larger-scale experimental studies are needed to provide sufficient evidences, and how to detect them quickly and at low cost is also a problem to be dealed with.
近年来,癌症治疗方法的快速发展极大地改善了癌症患者的预后。然而,随着癌症患者生存时间的延长,抗癌治疗带来的各种短期和长期副作用,尤其是心脏毒性,变得越来越突出。尽管如此,目前,几乎没有诊断方法具有极高的灵敏度和特异性,可以检测和准确预测接受抗癌治疗的患者是否会发生心血管并发症。炎症、纤维化和氧化应激被认为是抗癌治疗中心脏毒性的重要机制。与超声心动图监测的左心室射血分数相比,具有更早预测和检测心血管功能障碍能力的心血管生物标志物,对于及时调整治疗和预后评估具有重要价值。心肌肌钙蛋白 T/I 和脑利钠肽/脑利钠肽 N-末端前体已常规用于临床监测心脏毒性,一些新的生物标志物,如可溶性肿瘤抑制因子-2、髓过氧化物酶、生长分化因子-15、半乳糖凝集素-3、内皮素-1,在这方面具有潜力。未来需要更大规模的实验研究来提供充分的证据,如何快速、低成本地检测它们也是一个需要解决的问题。