中国全科医学 ›› 2025, Vol. 28 ›› Issue (24): 3072-3078.DOI: 10.12114/j.issn.1007-9572.2024.0374

所属专题: 乳腺癌最新文章合辑

• 综述与专论 • 上一篇    

乳腺癌治疗相关心脏毒性风险预测模型的研究进展

刘银银1, 隋鸿平1, 李婷婷2, 姜桐桐2, 史铁英1,2, 夏云龙1,2,*()   

  1. 1.116000 辽宁省大连市,大连医科大学
    2.116000 辽宁省大连市,大连医科大学附属第一医院
  • 收稿日期:2024-07-29 修回日期:2024-10-24 出版日期:2025-08-20 发布日期:2025-06-23
  • 通讯作者: 夏云龙

  • 作者贡献:

    刘银银负责文章的整体构思与设计,参与文献的整理与分析及论文撰写;隋鸿平、李婷婷负责收集与整理文献;姜桐桐、史铁英负责文章的质量控制及审校;夏云龙负责论文的修订、文章的质量控制及审校,对文章整体负责。

  • 基金资助:
    辽宁省自然科学基金资助项目(2022-BS-240); 大连市医学科学研究计划项目(2212016)

Advances in Risk Prediction Models for Cardiotoxicity Associated with Breast Cancer Treatment

LIU Yinyin1, SUI Hongping1, LI Tingting2, JIANG Tongtong2, SHI Tieying1,2, XIA Yunlong1,2,*()   

  1. 1. Dalian Medical University, Dalian 116000, China
    2. The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
  • Received:2024-07-29 Revised:2024-10-24 Published:2025-08-20 Online:2025-06-23
  • Contact: XIA Yunlong

摘要: 心脏毒性是乳腺癌患者癌症治疗过程中常见并发症,增加了患者身心痛苦,甚至可能危及生命,故早期识别高危患者并采取针对性预防措施至关重要。乳腺癌治疗相关心脏毒性风险预测模型是评估高危患者的重要方法,且已被国内外学者广泛研究。本文根据研究对象所接受的治疗方法,将现有模型分为特异性模型和普适性模型,并对各模型的构建过程与方法、预测因子、效果验证与应用等内容进行了详细阐述和比较分析。分析表明现有模型的构建方法主要采用Logistic回归和Cox比例回归等传统统计方法,少数使用机器学习算法,预测因子多为年龄、高血压、糖尿病、BMI、蒽环类药物、曲妥珠单抗和紫杉醇,预测性能良好,但各模型预测因子差异较大,且呈现重开发而轻应用的不平衡局面。未来研究应注重模型临床应用和本土化验证,结合人工智能技术,丰富新型建模方法,开展多中心、大样本前瞻性研究,提高模型稳定性,为临床医护人员识别心脏毒性提供有效筛查工具。本文能够为我国临床医护人员构建及应用乳腺癌治疗相关心脏毒性风险预测模型提供借鉴。

关键词: 心血管疾病, 心脏毒性, 乳腺肿瘤, 风险模型, 预测模型, 综述

Abstract:

Cardiotoxicity is a common complication during the cancer treatment of breast cancer patients, increasing their physical and mental suffering and even endangering their lives. Therefore, early identification of high-risk patients and taking targeted preventive measures is crucial. Risk prediction models for cardiotoxicity related to breast cancer treatment are important methods for assessing high-risk patients and have been extensively studied by scholars both domestically and internationally. The paper categorizes existing models into specific and general models based on the treatment methods received by the study population. It provides a detailed explanation and comparative analysis of the construction processes, methods, predictive factors, validation of effectiveness, and applications of these models. The analysis shows that the construction methods of existing models mainly use traditional statistical methods such as Logistic regression and Cox proportional regression, with a few using machine learning algorithms. The predictive factors are mostly age, hypertension, diabetes, and BMI, with good predictive performance. However, there are significant differences in the predictive factors among the models, and there is an imbalance between development and application. Future research should focus on clinical application and localization verification of models, combine artificial intelligence technology, enrich new modeling methods, and conduct multi-center, large-sample prospective studies to improve model stability. This will provide effective screening tools for clinical healthcare professionals to identify cardiotoxicity. This paper can serve as a reference for the construction and application of risk prediction models for cardiotoxicity related to breast cancer treatment by clinical healthcare professionals in China.

Key words: Cardiovascular diseases, Cardiotoxicity, Breast neoplasms, Hazard models, Prediction model, Review