关于高敏肌钙蛋白T (hs-TnT) 作为乳腺癌患者在曲妥珠单抗 (T) 治疗中心脏毒性的早期生物标志物存在争议。纳入了接受辅助治疗或新辅助治疗的早期HER2阳性乳腺癌患者。所有患者均进行了曲妥珠单抗治疗前和3、6、9个月时的经胸超声心动图检查和匹配的hs-TnT检测。充血性心力衰竭、心脏死亡、左室射血分数 (LVEF) 与基线相比下降超过10%，即使仍在正常范围内，或LVEF下降至55%以下均被视为心脏毒性征象。总共纳入24例患者 (年龄中位数：57岁；范围=39-79岁)。除了3例在曲妥珠单抗治疗前作为新/辅助治疗部分的方案中未使用蒽环类药物，其余所有患者均接受了蒽环类药物。观察到3例 (12.5%) 患者发生心血管毒性：两例无症状LVEF下降 (8.3%) 和一例心力衰竭发作 (4.2%)。在整个患者群中，基线hs-TnT水平的平均值为10.1±8.8 pg/ml，经过3、6和12个月后，没有观察到明显变化。出现心脏毒性的患者的平均hs-TnT水平高于无心脏毒性的患者 (18.3±12.3 vs. 8.2±7.2 pg/ml; p=0.049)。在卡方检验中显现出一定的趋势 (卡方值=3.52; p=0.06)。在早期乳腺癌蒽环类药物暴露患者中，hs-TnT可能能够鉴定出在新/辅助治疗期间存在心脏毒性风险的患者。版权所有 © 2023年，国际抗癌研究学院 (Dr. George J. Delinasios)，保留所有权利。

There is controversy around the use of high-sensitive troponin T (hs-TnT) as an early biomarker of cardiac toxicity in patients with breast cancer on trastuzumab (T).Patients receiving adjuvant or neo-adjuvant T for early HER2-positive breast cancer were prospectively included. Transthoracic echocardiograms and matched hs-TnT before T and at 3, 6, and 9 months were performed on all patients. Congestive heart failure, cardiac death, a decline in left ventricular ejection fraction (LVEF) of more than 10% from baseline even if it is still within the normal range, or a drop in LVEF below 55% were all considered signs of cardiac toxicity.In total, 24 patients (median age: 57; range=39-79 years) were enrolled. Anthracyclines were administered to all patients but three as part of neo/adjuvant treatment before T. Cardiovascular toxicity was observed in 3 out of 24 (12.5%) patients: two non-symptomatic LVEF declines (8.3%) and one heart failure episode (4.2%). In the entire population, the mean baseline hs-TnT level was 10.1±8.8 pg/ml, and after 3, 6, and 12 months, no appreciable change was observed. Patients with cardiac toxicity had mean hs-TnT levels higher than those without (18.3±12.3 vs. 8.2±7.2 pg/ml; p=0.049). A definite trend was evident in the chi-square test (chi2=3.52; p=0.06).In anthracycline-exposed patients with early breast cancer, hs-TnT may be able to identify those at risk of developing cardiac toxicity during neo/adjuvant T treatment.Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.