血清miR-21、miR-30b对乳腺癌患者术后曲妥珠单抗靶向治疗心脏毒性的预测价值

The predictive value of serum miR-21 and miR-30b for cardiac toxicity of trastuzumab targeted therapy in patients with breast cancer after surgery

目的探讨血清miR-21、miR-30b对乳腺癌患者术后曲妥珠单抗靶向治疗心脏毒性的预测价值。方法选取乳腺癌曲妥珠单抗靶向治疗患者138例为观察组,根据是否发生化疗相关心脏毒性事件分为非心脏毒性组和心脏毒性组2个亚组;另外选取同期体检健康女性150例为健康组。比较各组血清miR-21、miR-30b水平和临床资料。采用ROC评估血清miR-21、miR-30b对发生心脏毒性的预测价值,采用多因素Logistic回归分析发生心脏毒性的影响因素。结果观察组血清miR-21高于健康组,而miR-30b低于健康组;心脏毒性组血清miR-21和高血压占比高于非心脏毒性组,而miR-30b和左室射血分数(LVEF)低于非心脏毒性组(P<0.05)。LVEF、miR-21、miR-30b是乳腺癌术后化疗心脏毒性的影响因素(P<0.05)。血清miR-21、miR-30b联合预测乳腺癌术后化疗心脏毒性的诊断效能高于miR-21、miR-30b单独预测(P<0.05)。结论血清miR-21、miR-30b是乳腺癌术后化疗心脏毒性的影响因素,两者联合预测乳腺癌术后化疗心脏毒性的效能更高。

Aim To investigate the predictive value of serum miR-21 and miR-30b in the cardiac toxicity of trastuzumab targeted therapy after breast cancer surgery.Methods 138 patients with breast cancer who were treated with trastuzumab were selected as the observation group,and were divided into two subgroups:non-cardiotoxic group and cardiotoxic group according to whether there were chemotherapy-related cardiac toxicity events.In addition,150 healthy women who underwent physical examinations during the same period were selected as the healthy group.The levels of serum miR-21 and miR-30b and clinical data in each group were compared.ROC was used to evaluate the predictive value of serum miR-21 and miR-30b for the occurrence of cardiac toxicity,and multiple Logistic regression analysis was used to identify the influencing factors of cardiac toxicity.Results The serum miR-21 in the observation group were higher than that in the healthy group,while miR-30b was lower than that in the healthy group.The serum miR-21 and hypertension proportion in the cardiotoxic group were higher than that in the non-cardiotoxic group,while miR-30b and left ventricular ejection fraction(LVEF)were lower than that in the non-cardiotoxic group(P<0.05).LVEF,miR-21 and miR-30b were the influencing factors of cardiac toxicity of chemotherapy after breast cancer surgery(P<0.05).The diagnostic efficacy of serum miR-21 and miR-30b in predicting the cardiac toxicity of chemotherapy after breast cancer surgery was higher than that of miR-21 and miR-30b alone(P<0.05).Conclusion Serum miR-21 and miR-30b are the influencing factors of cardiac toxicity of chemotherapy after breast cancer surgery,and the combination of them is more effective in predicting the cardiac toxicity of chemotherapy after breast cancer surgery.