摘要
目的探讨热休克蛋白90α(HSP 90α)在胰腺癌患者中的表达及与传统肿瘤标志物(CEA、CA199、CA125)的相互关系。方法收集111例胰腺癌患者血浆中HSP90α、CEA、CA199、CA125数值,43例胰腺良性疾病者HSP90α数值。分析胰腺癌患者HSP90α水平及与临床病理因素、治疗疗效之间的关系,并与传统肿瘤标志物进行spearman相关性分析。结果胰腺癌患者血浆HSP90α水平及阳性率均明显高于胰腺良性疾病组(81.28 vs.51.72 ng/ml和47.7%vs.11.6%),差异均有统计学意义(均P<0.001)。(Ⅲ+Ⅳ)期、病理低分化、存在淋巴结转移胰腺癌患者的HSP 90α水平分别高于(Ⅰ+Ⅱ)期(P=0.013)、中高分化(P<0.001)、无淋巴结转移者(P=0.045)。胰腺癌患者的HSP 90α水平与年龄、性别、肿瘤发生部位及肿瘤大小无关,差异均无统计学意义(均P>0.05)。HSP 90α在胰腺癌诊断中的ROC曲线下面积为0.731(95%CI:0.647~0.815),其敏感度和特异度分别为54.1%和86.0%。胰腺癌患者HSP 90α水平与肿瘤标志物CEA、CA199、CA125之间没有明显的相关性(P>0.05)。HSP 90α与CEA、CA199、CA125四项联合诊断胰腺癌的敏感度为94.6%,明显高于单个肿瘤标志物(P<0.05),较CEA+CA199+CA125三项联合略增高,但差异无统计学意义(P>0.05)。胰腺癌患者治疗后疾病控制者血浆HSP 90α水平显著下降(76.37vs.60.43ng/ml;P=0.019),而疾病进展者血浆HSP 90α水平明显升高(84.705vs.120.395ng/ml;P=0.016)。胰腺癌患者中血浆HSP 90α正常者的PFS优于异常者(6个月vs.2.5个月),差异有统计学意义(P=0.016)。结论胰腺癌患者HSP 90α的表达明显高于良性疾病患者,与传统肿瘤标志物联合使用时可提高诊断胰腺癌的敏感度,对胰腺癌的辅助诊断及判断预后有指导作用。
Objective To investigate the value of heat shock protein 90α(HSP 90α) in pancreatic cancer patients and its correlation with traditional tumor markers(CEA,CA199,CA125).Methods The levels of Hsp 90α, CEA, CA199 and CA125 in plasma of one hundred and eleven patients with pancreatic cancer and forty-three patients with benign pancreatic diseases.The relationship between HSP 90α levels,clinicopathological factors and efficacy treatment in pancreatic cancer patients were analyzed.Then the relationship between HSP 90α and traditional tumor markers were analyzed by spearman correlation test.Results Higher HSP 90α levels and positive rate in pancreatic cancer patients were higher than that in benign pancreatic diseases patients(81.28 vs.51.72 ng/ml,P<0.001 and 47.7% vs.11.6%,P<0.001).HSP 90α levels in patients with stage Ⅲ+Ⅳ,low differentiation and lymphatic metastasis were higher than those in patients with stageⅠ+Ⅱ(P=0.013),medium and high differentiation(P<0.001) and without lymphatic metastasis(P=0.045),respectively.HSP 90α levels were not associated with the age,gender,tumor site and tumor size(P>0.05).In the diagnosis of pancreatic cancer,ROC curve indicates that AUC,sensitivity and specificity of HSP 90α were 0.731(95%CI:0.647-0.815),54.1% and 86%,respectively.There were no significant correlation between HSP 90α and CEA,CA199 and CA125 in pancreatic cancer patients(P>0.05).The sensitivity of HSP 90α combined with CEA,CA199 and CA125 in the diagnosis of pancreatic cancer was 94.6%,which was significantly higher than single tumor marker(P<0.05),and that was slightly higher than CEA+CA199+CA125 combined,but the difference was not statistically significant(P>0.05).Plasma HSP 90α levels was significantly reduced post-treatment in DC patients(76.37 vs.60.43 ng/ml,P=0.019),and it was increased in PD patients(84.705 vs.120.395 ng/ml,P=0.016).It showed that in pancreatic cancer patients, the PFS of patients with normal plasma Hsp 90α was better than those with abnormal Hsp 90α(6 months vs. 2.5 months
作者
张腾腾
顾康生
Zhang Tengteng;Gu Kangsheng(Department of Oncology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《中国煤炭工业医学杂志》
2020年第5期468-473,共6页
Chinese Journal of Coal Industry Medicine
基金
安徽省自然科学基金(编号:1808085MH306)。
