Plasma brain natriuretic peptide levels are elevated in patients with cancer.
Plasma brain natriuretic peptide levels are elevated in patients with cancer.
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DOI：
10.1371/journal.pone.0178607
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Sata M
中科院分区：
文献类型：
--
作者：
Bando S;Soeki T;Matsuura T;Tobiume T;Ise T;Kusunose K;Yamaguchi K;Yagi S;Fukuda D;Iwase T;Yamada H;Wakatsuki T;Shimabukuro M;Muguruma N;Takayama T;Kishimoto I;Kangawa K;Sata M
利钠肽被认为是心血管疾病，尤其是心力衰竭的生物标志物。脑利钠肽（BNP）也被证明在心肌细胞的促炎细胞因子的转录和翻译水平上调。虽然我们经常测量癌症患者血浆BNP水平，但癌症相关炎症是否影响血浆BNP水平仍不清楚。我们调查了BNP和人类癌症之间的关系。我们回顾性研究了2923例患者，测量了血浆BNP水平和血清c反应蛋白（CRP），并进行了超声心动图检查。排除有临床明显心衰（NYHA II或更高）、需要内科治疗或手术的心脏病、肾功能不全和炎症性疾病的患者。最终分析了234例患者。术前和化疗前均行采血。此外，我们还评估了结肠癌小鼠模型的炎症与血浆BNP水平之间的关系。在这234名患者中，有80人被诊断出患有癌症。癌症患者的血浆BNP和血清CRP水平均明显高于非癌症患者。两组超声心动图参数差异无统计学意义。肿瘤患者血浆BNP与血清CRP水平有显著正相关（r = 0.360， P<0.01），而非肿瘤患者血浆BNP与血清CRP水平无显著正相关。在癌症患者中，只有CRP与BNP相关，与年龄、肌酐水平、高血压和体重指数无关。此外，皮下结肠癌裸鼠血浆BNP水平较非癌小鼠升高，血浆BNP与血清炎症标志物水平有显著关系。在癌症患者和结肠癌模型小鼠中，血浆BNP水平升高，可能是由于癌症相关的炎症。当将BNP作为癌症患者心力衰竭的指标时，应考虑癌症对BNP水平的影响。
Natriuretic peptides have been proposed as biomarkers of cardiovascular disease, especially heart failure. Brain natriuretic peptide (BNP) has also been shown to be upregulated at the transcriptional and translational levels by pro-inflammatory cytokines in cardiac myocytes. Although we often measure plasma BNP levels in cancer patients, it remains unknown whether cancer-related inflammation affects the plasma BNP levels. We investigated the relationship between the BNP and human cancers. We retrospectively studied 2,923 patients in whom the plasma BNP levels and serum C-reactive protein (CRP) were measured and echocardiography was performed. Patients with clinically evident heart failure (NYHA II or higher), heart disease requiring medical treatment or surgery, renal dysfunction, and inflammatory disease were excluded. There were 234 patients in the final analysis. Blood sampling was performed before surgery and chemotherapy. In addition, we evaluated the relationship between the inflammation and plasma BNP levels in mouse models of colon cancer. Of the 234 patients, 80 were diagnosed with cancer. Both the plasma BNP and serum CRP levels were significantly higher in cancer patients than those without. There were no significant differences in the echocardiographic parameters. There was a significant positive correlation between the plasma BNP and serum CRP levels in cancer patients (r = 0.360, P<0.01) but not in those without. In cancer patients, only the CRP correlated with the BNP independent of the age, creatinine level, hypertension, and body mass index. In addition, in nude mice with subcutaneous colon cancer, the plasma BNP level was elevated compared with that in non-cancer mice, and there was a significant relationship between the plasma BNP and serum levels of the inflammatory markers. In cancer patients, as well as colon cancer model mice, the plasma BNP levels were elevated, possibly due to cancer-related inflammation. The effect of cancer on the BNP levels should be considered when using BNP as an indicator of heart failure in cancer patients.