热休克蛋白90a癌胚抗原与糖类抗原199在胃癌患者外周血中的表达与意义

The expression levels and clinical significances of Hsp90a CEA and CA199 in peripheral blood of patients with gastric cancer

目的探讨胃癌患者血浆中热休克蛋白90a(Hsp90a)、血清中癌胚抗原(CEA)和糖类抗原199(CA199)的表达水平及其对胃癌诊断及预后判定的临床价值。方法选取2018年1月至2019年1月安徽医科大学第一附属医院收治的86例初治胃癌患者为胃癌组,选取同期体检中心94例健康体检者作为对照组,采用酶联免疫法和电化学发光法检测两组患者外周血中Hsp90a、CEA和CA199的表达水平,分析对比单一及联合检测的阳性率、灵敏度及特异度,并按临床病理特征进行亚组分析。结果胃癌组患者的Hsp90a、CEA和CA199的表达水平均高于对照组[(100.38±74.68)vs(60.70±15.62)、(24.11±96.95)vs(2.24±1.51)和(167.96±1085.37)vs(11.16±15.23)],表达阳性率亦高于对照组,差异有统计学意义(P<0.05);胃癌组Hsp90a、CEA和CA199的单一检测胃癌的灵敏度分别为51.16%、30.23%和16.28%,差异有统计学意义(P<0.05),特异度差异无统计学意义(P>0.05),三者联合检测达到最高灵敏度,总体特异度有所下降;CEA、CA199的表达水平与淋巴结转移数目及临床分期呈显著正相关(P<0.05),Hsp90a与有无胸腹水、肿瘤部位、分化程度、浸润深度等临床特征无明显相关性(P>0.05)。结论胃癌患者外周血中的Hsp90a、CEA和CA199呈高表达,三者联合检测具有一定诊断效能。

Objective To investigate the expression levels of heat shock protein 90a(Hsp90a)in plasma of patients,carcinoembryonic antigen(CEA),and carbohydrate antigen 199(CA199)in serum of patients with gastric cancer and evaluate their diagnostic and prognostic values.Methods Eighty-six patients with newly diagnosed gastric cancer admitted to the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2019 were chosen as the gastric cancer group.Another 94 healthy subjects from the same physical examination center were randomly extracted as the control group,using enzyme-linked immuneosorbent assay and electrochemistry.The expression levels of Hsp90a,CEA and CA199 in peripheral blood of gastric cancer group and control group were identified by luminescence method.The positive rate,sensitivity and specificity of single and combined detection were analyzed,and subgroup analysis was carried out according to clinical pathological features.Results The expression levels of Hsp90a,CEA and CA199 in gastric cancer group were higher than those in control group[(100.38±74.68)vs(60.70±15.62),(24.11±96.95)vs(2.24±1.51),and(167.96±1085.37)vs(11.16±15.23)],the positive rate of expressions was also higher than that of control group,and the difference was statistically significant(P<0.05).The sensitivity of single detection of gastric cancer in Hsp90a,CEA and CA199 was 51.16%,30.23% and 16.28%,respectively,and the difference was statistically significant(P<0.05),but there was no significant difference between the specificity groups(P>0.05).The combination of the three tests reached the highest sensitivity and the overall specificity decreased.There was a major positive correlation between the expression levels of CEA and CA199 and the number of lymph node metastasis and clinical stage(P<0.05).There was not any significant correlation between Hsp90a and clinical features such as presence or absence of thoracic and ascites,tumor location,differentiation degree and depth of invasion(P>0.05).Conclu sions Hsp90a,CEA,and CA199 are highly expressed in peripheral blood of patients with gastric cancer.The combination detection of the three can get certain diagnostic efficiency in gastric cancer diagnosis.