N末端B型脑利钠肽前体对乳腺癌蒽环类化疗相关心脏毒性的预测价值被引量：3

Predictive value of NT-proBNP in anthracycline-based chemotherapy-related cardiotoxicity of breast cancer

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摘要目的探讨N末端B型脑利钠肽前体（NT-proBNP）在乳腺癌蒽环类化疗相关心脏毒性的诊断价值.方法检测135例乳腺癌蒽环类化疗患者血浆NT-proBNP浓度,分析其化疗前后浓度变化与心脏毒性发生的关系,分析其诊断心脏毒性的浓度水平.结果 22例（16.29％）患者出现心脏毒性,心脏毒性组患者血浆中NT-proBNP水平显著高于无毒性组（P＜0.05）;根据ROC曲线,NT-proBNP诊断乳腺癌化疗后心脏毒性的曲线下面积为0.752（95％ CI：0.635 ～0.918）,综合考虑ROC曲线,设血浆NT-proBNP水平350 pg/ml为诊断心脏毒性的临界点,其诊断乳腺癌蒽环类相关心脏毒性的敏感度和特异度分别为70.32％、82.58％,阳性预测值为78.12％,阴性预测值为65.45％.结论证实NT-proBNP在早期诊断乳腺癌蒽环类化疗后相关心脏毒性的应用价值,提示其可能成为较理想的心脏毒性预测标志物之一. Objective To explore the predictive value of serum N-terminal pro-brain natriuretic peptide （NT-proBNP） level in anthracycline-based chemotherapy-related cardiotoxicity of breast cancers.Methods A total of 135 breast cancer patients was analyzed if NT-proBNP was associated with chemotherapy-related cardiotoxicity.The level of NT-proBNP in the diagnosis of cardiotoxicity was assessed.Results A total of 22 patients （16.29%） had subsequent claims for cardiotoxicity events.NT-proBNP in cardiotoxicity group was significantly higher than that non-cardiotoxicity group （P 〈 0.05）.According to receiver operating characteristic （ROC） curve, the cut-off value of NT-proBNP was set at 350 pg/ml, specificity and sensitivity were 70.32% and 82.58% , respectively.Positive and negative predictive values were 78.12% and 65.45%, respectively.Conclusions The present study is to confirm excellent clinical value of NTproBNP on cardiotoxicity.The level of NT-proBNP for early detection of cardiotoxicity has good prospects for high risk patients.

作者龙惠东林云恩刘观成闫冰川梁傍顺廖志伟戴诗蕾

机构地区广州医科大学附属肿瘤医院肿瘤科广州医科大学附属肿瘤医院B超室广州医科大学附属肿瘤医院放疗四科广州医科大学附属肿瘤医院第一附属医院病理科

出处《中国医师杂志》 CAS 2015年第10期1516-1519,共4页 Journal of Chinese Physician

基金基金项目：广州市中医药科技资助项目（20142A011024,20152A011023）

关键词利钠肽脑/代谢乳腺肿瘤/代谢/药物疗法蒽环类/治疗应用/副作用心脏/药物作用 Natriuretic peptide,brain/ME Breast neoplasms/ME/DT Anthracyclines/TU/AE Heart/DE

分类号 R737.9 [医药卫生—肿瘤]

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