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儿童癌症成年幸存者的血管评估:圣犹大终身队列研究报告

Vascular Assessment in Adult Survivors of Childhood Cancer: A St. Jude Lifetime Cohort Study Report.

作者信息

Berkman Amy M, Wang Mingjuan, Santucci Aimee, Duprez Daniel, Solovey Anna N, Srivastava Deokumar, Joshi Vijaya M, Green Daniel M, Robison Leslie L, Ness Kirsten K, Hudson Melissa M, Mulrooney Daniel A

机构信息

Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.

Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.

出版信息

JACC Adv. 2025 Jun;4(6 Pt 1):101820. doi: 10.1016/j.jacadv.2025.101820. Epub 2025 May 29.

DOI:10.1016/j.jacadv.2025.101820
PMID:40446733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12166415/
Abstract

BACKGROUND

While end-organ toxicities following cancer therapy have been well described, long-term vascular health has received less attention.

OBJECTIVES

The purpose of this study was to evaluate vascular health in childhood cancer survivors (CCSs) utilizing established and novel biomarkers and measures of arterial function.

METHODS

Serum biomarkers of inflammation (high-sensitivity C-reactive protein), hemostasis (fibrinogen, D-dimer, plasminogen activator inhibitor-1, tissue type plasminogen activator, von-Willebrand factor), and vasoregulation (surface and soluble vascular cell adhesion molecule-1 and P-selectin) were measured in this cross-sectional cohort study. Large and small arterial elasticity, pulse wave velocity, and augmentation index (AIx) were assessed. Differences between CCSs and sex- and age-matched controls were assessed in multivariable general linear regression models, adjusted for body mass index, race and ethnicity, smoking, and physical activity.

RESULTS

Among 200 CCSs (median time from diagnosis 26.3 years [range: 11.2-47.9 years], current age 33.5 years [range: 19.3-61.6 years]) and 192 controls (33.3 years [range: 18.3-60.3 years]), plasminogen activator inhibitor-1 (1,804.7 pg/mL vs 1,577.9 pg/mL, P = 0.007) and endothelial surface expression of vascular cell adhesion molecule-1 (67.6% vs 43.5%; P < 0.001) and P-selectin (65.7% vs 45.9%; P < 0.001) were significantly elevated in CCSs compared to controls. Large artery elasticity (16.8 mL/mm Hg × 10 vs 18.1 mL/mm Hg × 10; P = 0.013) and small artery elasticity (7.1 mL/mm Hg × 100 vs 8.7 mL/mm Hg × 100; P < 0.001) were reduced, while pulse wave velocity (6.8 m/s vs 6.3 m/s; P < 0.001) and AIx (13.3% vs 8.1%; P < 0.001) were significantly elevated. AIx was higher among survivors exposed to chest radiation (15.4%) compared to those not exposed (11.2%).

CONCLUSIONS

CCSs have evidence of early vascular dysfunction, suggestive of premature atherogenesis.

摘要

背景

虽然癌症治疗后的终末器官毒性已得到充分描述,但长期血管健康受到的关注较少。

目的

本研究的目的是利用已确立的和新的生物标志物以及动脉功能测量方法来评估儿童癌症幸存者(CCSs)的血管健康状况。

方法

在这项横断面队列研究中,测量了炎症(高敏C反应蛋白)、止血(纤维蛋白原、D - 二聚体、纤溶酶原激活物抑制剂 - 1、组织型纤溶酶原激活物、血管性血友病因子)和血管调节(表面和可溶性血管细胞粘附分子 - 1以及P - 选择素)的血清生物标志物。评估了大动脉和小动脉弹性、脉搏波速度和增强指数(AIx)。在多变量一般线性回归模型中评估了CCSs与性别和年龄匹配的对照组之间的差异,并对体重指数、种族和民族、吸烟和身体活动进行了调整。

结果

在200名CCSs(诊断后的中位时间为26.3年[范围:11.2 - 47.9年],当前年龄为33.5岁[范围:19.3 - 61.6岁])和192名对照组(33.3岁[范围:18.3 - 60.3岁])中,与对照组相比,CCSs的纤溶酶原激活物抑制剂 - 1(1,804.7 pg/mL对1,577.9 pg/mL,P = 0.007)、血管细胞粘附分子 - 1的内皮表面表达(67.6%对43.5%;P < 0.001)和P - 选择素(65.7%对45.9%;P < 0.001)显著升高。大动脉弹性(16.8 mL/mm Hg×10对18.1 mL/mm Hg×10;P = 新的生物标志物以及动脉功能测量方法来评估儿童癌症幸存者(CCSs)的血管健康状况。

方法

在这项横断面队列研究中,测量了炎症(高敏C反应蛋白)、止血(纤维蛋白原、D - 二聚体、纤溶酶原激活物抑制剂 - 1、组织型纤溶酶原激活物、血管性血友病因子)和血管调节(表面和可溶性血管细胞粘附分子 - 1以及P - 选择素)的血清生物标志物。评估了大动脉和小动脉弹性、脉搏波速度和增强指数(AIx)。在多变量一般线性回归模型中评估了CCSs与性别和年龄匹配的对照组之间的差异,并对体重指数、种族和民族、吸烟和身体活动进行了调整。

结果

在200名CCSs(诊断后的中位时间为26.3年[范围:11.2 - 47.9年],当前年龄为33.5岁[范围:19.3 - 61.6岁])和192名对照组(33.3岁[范围:18.3 - 60.3岁])中,与对照组相比,CCSs的纤溶酶原激活物抑制剂 - 1(1,804.7 pg/mL对1,以及P - 选择素(65.7%对45.9%;P < 0.001)显著升高。大动脉弹性(16.8 mL/mm Hg×10对18.1 mL/mm Hg×10;P = 0.013)和小动脉弹性(7.1 mL/mm Hg×100对8.7 mL/mm Hg×100;P < 0.001)降低,而脉搏波速度(6.8 m/s对6.3 m/s;P < 0.001)和AIx(13.3%对8.1%;P < 0.001)显著升高。与未接受胸部放疗的幸存者(11.2%)相比,接受胸部放疗的幸存者的AIx更高(15.4%)。

结论

CCSs有早期血管功能障碍的证据,提示过早发生动脉粥样硬化。 013)和小动脉弹性(7.1 mL/mm Hg×100对8.7 mL/mm Hg×100;P < 0.001)降低,而脉搏波速度(6.8 m/s对6.3 m/s;P < 0.001)以及P - 选择素(65.7%对45.9%;P < 0.001)显著升高。大动脉弹性(16.8 mL/mm Hg×10对18.1 mL/mm Hg×10;P = 0.013)和小动脉弹性(7.1 mL/mm Hg×100对8.7 mL/mm Hg×100;P < 0.001)降低,而脉搏波速度(6.8 m/s对6.3 m/s;P < 0.001)和AIx(13.3%对8.1%;P < 0.001)显著升高。与未接受胸部放疗的幸存者(11.2%)相比,接受胸部放疗的幸存者的AIx更高(15.4%)。

结论

CCSs有早期血管功能障碍的证据,提示过早发生动脉粥样硬化。 013)和小动脉弹性(7.1 mL/mm Hg×100对8.7 mL/mm Hg×100;P < 0.001)降低,而脉搏波速度(6.8 m/s对6.3 m/s;P < 0.001)和AIx(13.3%对8.1%;P < 0.001)显著升高。与未接受胸部放疗的幸存者(11.2%)相比,接受胸部放疗的幸存者的AIx更高(15.4%)。

结论

CCSs有早期血管功能障碍的证据,提示过早发生动脉粥样硬化。

注

原文中部分内容重复,翻译时尽量完整呈现了重复部分,确保信息完整准确。你可根据实际需求对译文进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25e0/12166415/b1bd4c5eb642/gr3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25e0/12166415/b1bd4c5eb642/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25e0/12166415/b1bd4c5eb642/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25e0/12166415/daa36032acf1/gr1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25e0/12166415/b1bd4c5eb642/gr3.jpg

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