热休克蛋白90α在非小细胞肺癌患者血浆中的表达及应用价值

Expression and Application Value of Heat Shock Protein 90 α in Plasma of Patients with Non-small Cell Lung Cancer

目的 探讨热休克蛋白90α(Hsp90α)在非小细胞肺癌患者血浆中的表达及应用价值。方法 选取2020年8月-2022年1月于我院经临床和病理确诊为非小细胞肺癌患者61例设为肺癌组,肺部良性疾病患者51例设为肺部良性疾病组,同期32例健康体检人员作为健康对照组。比较各组Hsp90α、癌胚抗原(CEA)、糖链抗原125(CA125)、细胞角质蛋白19片段(CYFRA21-1)、鳞状细胞癌抗原(SCCAg),并采用受试者工作特征(ROC)曲线分析各肿瘤标志物单独及联合检测的曲线下面积(AUC)及诊断非小细胞肺癌的敏感性、特异性。结果 肺癌组Hsp90α、CEA、CA125、SCCAg、CYFRA21-1高于肺部良性疾病组、健康对照组,差异有统计学意义(P<0.05);腺癌CEA、CA125水平高于鳞癌,CYFRA21-1、SCCAg水平低于鳞癌,差异有统计学意义(P<0.05);鳞癌和腺癌Hsp90α水平比较,差异无统计学意义(P>0.05);ROC曲线分析显示,血浆Hsp90α在肺癌诊断中的最佳临界值为101.99 ng/ml,其灵敏度为75.40%,特异度为74.50%;Hsp90α联合其他三项肿瘤标志物诊断非小细胞肺癌时AUC最大,为0.903。当使用特异性为90%时的值为阳性判定值,Hsp90α的敏感度为21.30%,而Hsp90α、CEA、SCC、CYFRA21-1四项联合使用的敏感度达到75.40%。结论 Hsp90α可作为非小细胞肺癌辅助诊断的血清标志物之一,与其他标志物联合检测可显著提高非小细胞肺癌的检出率,在非小细胞肺癌的早期诊断中有重要的临床价值。

Objective To investigate the expression and application value of heat shock protein 90α(Hsp90α) in plasma of patients with non-small cell lung cancer.Methods From August 2020 to January 2022, 61 patients with non-small cell lung cancer diagnosed by clinical and pathological diagnosis in our hospital were selected as lung cancer group, 51 patients with benign lung disease were selected as benign lung disease group, and 32healthy people were selected as healthy control group. Hsp90α, carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125), cytokeratin 19fragment(CYFRA21-1), squamous cell carcinoma antigen(SCCAg) were compared among groups. The receiver operating characteristic(ROC) curve was used to analyze the area under the curve(AUC) of each tumor marker alone and combined detection and the sensitivity and specificity of diagnosis of non-small cell lung cancer.Results The levels of Hsp90α, CEA, CA125, SCCAg and CYFRA21-1 in lung cancer group were significantly higher than those in benign disease group and healthy control group(P<0.05). The levels of CEA and CA125 in adenocarcinoma were higher than those in squamous cell carcinoma, and the levels of CYFRA21-1 and SCCAg were lower than those in squamous cell carcinoma group(P<0.05), but there was no significant difference in the level of Hsp90α between squamous cell carcinoma and adenocarcinoma(P >0.05). ROC curve analysis showed that the optimal critical value of plasma Hsp90α in the diagnosis of lung cancer was 101.99 ng/ml, with a sensitivity of 75.40% and a specificity of 74.50%. The AUC of Hsp90α combined with other three tumor markers in the diagnosis of non-small cell lung cancer was the largest,which was 0.903. When the specificity was 90%, the sensitivity of Hsp90α was 21.30%, while the sensitivity of Hsp90α, CEA, SCC and CYFRA21-1was 75.40%.Conclusion Hsp90 α can be used as one of the markers for the auxiliary diagnosis of non-small cell lung cancer. Combined with other markers, it can significantly improve the detection rate of non-small cell lung cancer, and has important clinical value in the early diagnosis of nonsmall cell lung cancer.