Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (4): 333-341.doi: 10.24920/003790

• 综述 • 上一篇    下一篇

抗癌治疗中对心脏毒性效应具有潜在预测价值的生物标志物

杨威,张梅()   

  1. 山东大学齐鲁医院心内科,山东 济南 250012 中国
  • 收稿日期:2020-06-07 出版日期:2021-12-31 发布日期:2022-01-06
  • 通讯作者: 张梅 E-mail:daixh@vip.sina.com

Biomarkers with Potential Predictive Value for Cardiotoxicity in Anticancer Treatments

Wei Yang,Mei Zhang()   

  1. 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
  • Received:2020-06-07 Published:2021-12-31 Online:2022-01-06
  • Contact: Mei Zhang E-mail:daixh@vip.sina.com

摘要:

抗癌治疗在延长肿瘤患者生存期的同时,抗癌治疗引起的各种近期和远期副作用,尤其是心脏毒性显得日益突出。然而,对于恶性肿瘤患者是否会经历心血管并发症,尚无敏感度及特异度极高的早期发现和准确预测手段。炎症、纤维化和氧化应激被认为是抗癌治疗引发心脏毒性的重要机制。相对于临床症状和左室射血分数,相关的心血管生物标志物可能具有更早发现心血管功能紊乱的能力,对于及时肿瘤调整治疗方案以及患者预后评估具有更大价值。临床上,心肌肌钙蛋白T/I和脑钠肽/N-末端脑钠肽前体已被推荐用于常规心脏毒性监测,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具有潜在的研究价值。在应用于临床之前,需要大样本的试验证实其有效性,同时提高易操作性、降低成本。

关键词: 生物标志物, 心脏毒性, 抗癌治疗, 综述

Abstract:

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.

Key words: biomarkers, cardiotoxicity, anticancer treatments, review

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