一种新型《乳腺癌治疗相关心血管毒性临床评分表》的价值分析

章箎; 陈佳慧; 林瑾仪; 王妍; 张斯加; 朱玮; 程蕾蕾

doi:10.19401/j.cnki.1007-3639.2022.01.007

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一种新型《乳腺癌治疗相关心血管毒性临床评分表》的价值分析

论著 | 更新时间：2025-12-31

- 一种新型《乳腺癌治疗相关心血管毒性临床评分表》的价值分析
- Validation of a scale for evaluating the cardiovascular risk after breast cancer therapy: the clinical scale for breast cancer treatment related cardiovascular toxicity
- 中国癌症杂志 2022年32卷第1期页码：54-60
- 作者机构：
  
  1. 复旦大学附属中山医院心内科,上海 200032
  2. 上海市心血管病研究所,上海 200032
  3. 复旦大学附属中山医院肿瘤内科,上海 200032
  4. 复旦大学附属中山医院普外科,上海 200032
  5. 复旦大学附属中山医院心脏超声诊断科,上海 200032
  6. 上海市影像医学研究所,上海 200032
- 作者简介：
  
  程蕾蕾 E-mail: cheng.leilei@zs-hospital.sh.cn
- 基金信息：
  
  国家自然科学基金(81771840);上海市徐汇区科学技术委员会防控新型冠状病毒肺炎疫情人工智能创新应用项目(Q2020-011);复旦大学附属中山医院临床研究专项(2020ZSLC21);复旦大学附属中山医院智慧医疗专项(2020ZHZS16)
- DOI：10.19401/j.cnki.1007-3639.2022.01.007
  中图分类号： R737.9
- 收稿：2021-09-07，
  
  修回：2021-11-29，
  
  纸质出版：2022-01-30
- 稿件说明：
移动端阅览
章箎, 陈佳慧, 林瑾仪, 等. 一种新型《乳腺癌治疗相关心血管毒性临床评分表》的价值分析[J]. 中国癌症杂志, 2022,32(1):54-60.

Chi ZHANG, Jiahui CHEN, Jinyi LIN, et al. Validation of a scale for evaluating the cardiovascular risk after breast cancer therapy: the clinical scale for breast cancer treatment related cardiovascular toxicity[J]. China Oncology, 2022, 32(1): 54-60.
章箎, 陈佳慧, 林瑾仪, 等. 一种新型《乳腺癌治疗相关心血管毒性临床评分表》的价值分析[J]. 中国癌症杂志, 2022,32(1):54-60. DOI： 10.19401/j.cnki.1007-3639.2022.01.007.

Chi ZHANG, Jiahui CHEN, Jinyi LIN, et al. Validation of a scale for evaluating the cardiovascular risk after breast cancer therapy: the clinical scale for breast cancer treatment related cardiovascular toxicity[J]. China Oncology, 2022, 32(1): 54-60. DOI： 10.19401/j.cnki.1007-3639.2022.01.007.

摘要

背景与目的：

乳腺癌治疗相关心血管疾病已成为乳腺癌患者死亡的原因之一

为协助临床肿瘤科医师对患者的心血管疾病风险因素进行筛查

复旦大学附属中山医院肿瘤心脏病学团队拟定《乳腺癌治疗相关心血管毒性临床评分表》

协助临床医师对乳腺癌非手术患者进行评估

并采用该评分表对复旦大学附属中山医院的乳腺癌患者进行回顾性分析。

方法：

本研究为单中心的回顾性研究。2017年1月1日

#x02014;2018年12月31日共有760例患者符合回顾性研究的纳入标准。研究收集符合入组条件的患者

统计心血管风险的发病率并分析患者心血管随访记录。用评分表对每例患者进

行评估

从而验证评分表的可重复性、灵敏度、特异度、一致性及便捷性。

结果：

入组人群平均随访天数（746.55

#x000b1;309.94）d

平均入选年龄（56.60

#x000b1;12.62）岁。共有36例患者出现新发的严重心律失常

新发心肌损伤8例

新发心功能不全6例。使用蒽环类药物的患者在基线后半年至1年、1年及以上复查NT-proBNP的随访比例分别为34.31%、29.62%

复查超声心动图的随访比例分别为35.48%、32.48%。评分表对中高危检测的灵敏度为0.828

特异度为0.934

总体准确率度0.921;对高危检测的灵敏度为0.983

特异度为0.986

总体准确度为0.986。与临床判断的线性一致性为

#x003ba;=0.633

0.05。评分表简便可行

平均完成时间为（108.67

#x000b1;44.86）s。

结论：

心血管疾病在乳腺癌非手术治疗患者中的发病率甚至超过肿瘤本身。因此

对于心血管疾病的监测必不可少。本研究提供了一种简易可行的量表

具有较高的准确度、特异度及便捷性

有望在不断改进的同时将其进一步推广。

Abstract

Background and purpose:

The treatment-related cardiovascular disease in patients with breast cancer poses a greater mortality threat than cancer itself. To assist clinical oncologist

we introduced a scale to help clinicians by screening out patients with breast cancer who were at risk of cardiovascular diseases. The breast cancer patients in Zhongshan Hospital

Fudan University were analyzed retrospectively by the scale.

Methods:

This was a single center

retrospective trial. A total of 760 patients who met the inclusion and exclusion criteria were enrolled in this trial from January 1

2017 to December 31

2018. The incidence rate of cardiovascular risk was collected from patients eligible for admission. Secondly

follow-up information for each patient was evaluated by the scale and the clinician. The repeatability

sensitivity

specificity and consistency of the scale were evaluated.

Results:

The average follow-up duration was (746.55

#x000b1;309.94) d

and the average population age was (56.60

#x000b1;12.62) years. A total of 36 patients developed severe arrhythmias during or after the treatment

8 patients with emerging myocardial injury and 6 patients with emerging cardiac insufficiency. The follow-up rates of patients with test for NT-proBNP from half a year to one year and more than one year after baseline were 34.31% and 29.62%

while 35.

48% and 32.48% for those who took echocardiography. The sensitivity

specificity and overall accuracy of medium-and high-risk patient tests were 0.828

0.934 and 0.921

respectively. The sensitivity

specificity and overall accuracy of high-risk patient tests were 0.983

0.986

and 0.986

respectively. The linear consistency with clinical judgment was

#x003ba;=0.633

0.05. The average time for completion of the scale was (108.67

#x000b1;44.86) s.

Conclusion:

The incidence rate of cardiovascular disease in breast cancer patients is even higher than that of cancer itself. Therefore

it is essential to monitor cardiovascular disease. In this trial

we provide a simple and feasible scale

which has high accuracy

specificity and convenience. We hope to promote it as soon as possible.

关键词

Keywords

references

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