Chen Cuncun, Zheng Hui, Wang Yanchun, Tong Ying, Zhang Heng, Xie Suhong, Ma Xiaolu, Jiang Minglei, Gong Zhiyun, Yan Tianqing, Tian Yanan, Guo Lin, Lu Renquan
Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China.
Front Cardiovasc Med. 2024 Dec 12;11:1477679. doi: 10.3389/fcvm.2024.1477679. eCollection 2024.
Cardiovascular biomarkers are crucial for monitoring cancer therapy-related cardiac toxicity, but the effects on early stage are still inadequate. To screen biomarkers in patients with breast cancer who receive anthracycline-containing chemotherapy, we studied the behavior of six biomarkers during chemotherapy and their association with chemotherapy-related cardiac toxicity.
In a prospective cohort of 73 patients treated with anthracycline-containing chemotherapy, soluble suppression of tumorigenicity 2 (sST2), high-sensitivity cardiac troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), myoglobin, creatine kinase isoenzyme MB, and heart-fatty acid binding protein were measured at baseline, during chemotherapy cycle (C1-C6). According to whether arrhythmia occurred, patients were divided into two groups (healthy group or arrhythmias group), and basic clinical characteristics were collected and compared. Logistic regression analyses and receiver operating characteristic (ROC) curves were conducted to investigate the association between the changes in biomarkers and arrhythmia.
sST2 levels increased significantly from baseline to C1 ( < 0.01). NT-proBNP levels decreased from baseline to C1 and C5 ( < 0.01). The logistic regression analysis showed a greater risk of arrhythmia was associated with interval changes in sST2 [odds ratio (OR): 1.27; 95% CI: 1.03-1.56; = 0.024] and NT-proBNP (OR: 0.83; 95% CI: 0.70-0.98; = 0.029). The ROC curves showed that ΔsST2, ΔNT-proBNP, and ΔsST2 + ΔNT-proBNP had good predictive value for arrhythmia (areas under the curves were 0.631, 0.633, and 0.735, respectively, < 0.05).
Early changes in sST2 and NT-proBNP levels offer additive information for early arrhythmia prediction in breast cancer patients who receive anthracycline-containing chemotherapy.
心血管生物标志物对于监测癌症治疗相关的心脏毒性至关重要，但对早期阶段的影响仍不充分。为了筛选接受含蒽环类化疗的乳腺癌患者的生物标志物，我们研究了六种生物标志物在化疗期间的变化及其与化疗相关心脏毒性的关联。
在一个73例接受含蒽环类化疗患者的前瞻性队列中，于基线、化疗周期（C1 - C6）期间测量可溶性肿瘤抑制因子2（sST2）、高敏心肌肌钙蛋白T、N末端B型利钠肽原（NT - proBNP）、肌红蛋白、肌酸激酶同工酶MB和心脏脂肪酸结合蛋白。根据是否发生心律失常，将患者分为两组（健康组或心律失常组），并收集和比较基本临床特征。进行逻辑回归分析和受试者工作特征（ROC）曲线分析，以研究生物标志物变化与心律失常之间的关联。
sST2水平从基线到C1显著升高（<0.01）。NT - proBNP水平从基线到C1和C5降低（<0.01）。逻辑回归分析显示，心律失常风险增加与sST2的区间变化[比值比（OR）：1.27；95%可信区间（CI）：1.03 - 1.56；P = 0.024]和NT - proBNP（OR：0.83；95%CI：0.70 - 0.98；P = 0.029）相关。ROC曲线显示，ΔsST2、ΔNT - proBNP和ΔsST2 + ΔNT - proBNP对心律失常具有良好的预测价值（曲线下面积分别为0.631、0.633和0.735，P < 0.05）。
sST2和NT - proBNP水平的早期变化为接受含蒽环类化疗的乳腺癌患者早期心律失常预测提供了补充信息。
