Hsp90α及SCC在宫颈癌早期诊断及预后监测中的价值

The value of Hsp90 α and SCC in early diagnosis and prognosis monitoring of cervical cancer

目的探讨血浆热休克蛋白90α(heat shock protein 90α,Hsp90α)及鳞状细胞癌相关抗原(squamous cell carcinoma antigen,SCC)在宫颈癌早期诊断以及预后监测中的价值。方法选取2015年4月~2017年6月我院肿瘤科收治的96例宫颈癌患者作为宫颈癌组,选取同期50例子宫上皮内瘤变患者作为子宫上皮内瘤变组,50例正常健康女性作为正常对照组。宫颈癌组取术前3天、术后3天、术后1周的EDTA-K2抗凝血液标本和促凝血液标本分别2ml,子宫上皮内瘤变组及正常对照组均采取EDTA-K2抗凝血液标本2ml,离心后于-80℃冰箱保存,用化学发光法测定SCC水平,用酶联免疫法测定Hsp90α水平,采用受试者工作特征曲线(Receiver operating characteristic curve,ROC曲线)评估SCC、Hsp90α水平对宫颈癌早期诊断的价值以及在不同肿瘤临床分期、分化程度、是否转移、肿瘤大小等情况下Hsp90α、SCC水平对患者预后价值评估。结果宫颈癌组患者Hsp90α和SCC水平均高于子宫上皮内瘤变组和正常对照组,差异均有统计学意义(P<0.05);宫颈癌中血浆SCC的诊断符合率显著低于Hsp90α,差异有统计学意义(P<0.05),Hsp90α阳性率高于SCC阳性率,比较差异有统计学意义(P<0.05);宫颈癌治疗后Hsp90α和SCC水平均有所下降,且与治疗前比较差异有统计学意义(P<0.05)。随访1年中,8例出现宫颈癌复发,Hsp90α检测水平明显高于与未复发患者,差异有统计学意义(P<0.05);Hsp90α与肿瘤临床分期、分化程度、是否转移、肿瘤大小有关(P<0.05),SCC与肿瘤临床分期有关(P<0.05)。结论血浆Hsp90α和血清SCC水平均可作为宫颈癌的预测指标,但Hsp90α预测效果优于血清SCC水平,血浆Hsp90α可作为宫颈癌的可靠诊断指标,能够作为术后治疗效果评估指标,与肿瘤分期、分级、是否转移有关,两者联合检测可降低误诊率。

Objective To investigate the value of plasma heat shock protein 90 α(Hsp90 α) and squamous cell carcinoma antigen(SCC) in early diagnosis and prognosis monitoring of cervical cancer. Methods From April 2015 to June 2017, 96 patients with cervical cancer were selected as cervical cancer group. 50 cases of endometrial neoplasia in the same period were selected as the endometrial neoplasia group. 50 healthy women were taken as the control group. In the cervical cancer group, 2 ml of EDTA K2 anticoagulant blood samples and accelerating blood samples were taken 3 days before operation, 3 days after operation and 1 week after operation. 2 ml of EDTA K2 anticoagulant blood samples were taken in the uteri intraepithelial neoplasia group and the normal control group, and stored in refrigerator at 80 ℃ after centrifugation. The SCC level was determined by chemiluminescence. The level of Hsp90 α was determined by ELISA. SCC was evaluated by receiver operating characteristic curve(ROC curve). The value of Hsp90 α level in the early diagnosis of cervical cancer and in the prognosis of patients with different tumor stages, differentiation, metastasis and tumor size were analyzed.Results The levels of Hsp90 α and SCC in cervical cancer group were higher than those in utero intraepithelial neoplasia group and normal control group, and the difference was statistically significant(P<0.05). The diagnostic accuracy of SCC in cervical cancer was significantly lower than that of Hsp90 α(P<0.05). The positive rate of Hsp90 α was higher than that of SCC(P<0.05). After treatment, the levels of Hsp90 α and SCC decreased, and the difference was statistically significant(P<0.05). In the follow-up of one year, 8 cases of cervical cancer recurred, the detection level of Hsp90 α was significantly higher than that of the non recurred patients, the difference was statistically significant(P<0.05). Hsp90 α was related to clinical stage, differentiation, metastasis and tumor size(P<0.05). SCC was related to the clinical stage of tumor(P<005). Conclusion Plasma Hsp90 α and serum SCC can be used as the prediction indexes of cervical cancer, but the prediction effect of HSPPO is better than that of serum SCC. Plasma HSPPoa can be used as the reliable diagnosis index of cervical cancer, and can be used as the evaluation index of postoperative treatment effect, which is related to tumor stage, grade and metastasis. The combined detection of the two groups can reduce the misdiagnosis rate.