热休克蛋白90α在胰腺癌组织中的表达及其对胰腺癌的诊断价值分析  

The expression of heat shock protein 90αin pancreatic cancer and its diagnostic value

作　　者：常思远 李文迪 冷开明 刘彩云[2] 史光军[2] Chang Siyuan;Li Wendi;Leng Kaiming;Liu Caiyun;Shi Guangjun(Qingdao Medical College,Qingdao University,Qingdao 266000,China;Department of Hepatobiliary and Pancreatic Surgery,Qingdao Municipal Hospital,Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学青岛医学院,青岛266000 [2]青岛大学青岛市市立医院肝胆胰外科,青岛266000

出　　处：《中华肝胆外科杂志》2025年第3期188-192,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的分析热休克蛋白90α(HSP90α)在胰腺癌组织中的表达以及对胰腺癌的潜在诊断价值。方法回顾性收集2018年1月至2023年5月就诊于青岛市市立医院的99例胰腺癌患者手术标本和临床资料,其中男性58例,女性41例,年龄(63.5±23.5)岁。99例患者中44例(44.4%)用于病理学检查和预后分析,55例(55.6%)检测血浆HSP90α水平,评估对胰腺癌的诊断效果。收集同期同一医院体检正常者血液样本共119例,其中男性74例,女性45例,年龄(50.5±25.5)岁,检测血浆HSP90α水平。免疫组化检测癌组织和癌旁组织HSP90α的表达。受试者工作特征(ROC)曲线分析HSP90α、癌胚抗原、糖类抗原19-9、糖类抗原125诊断胰腺癌的效果。生存分析采用Kaplan-Meier法,log-kank检验比较生存率。癌组织中HSP90α阳性表达与突变型p53阳性表达采用Spearman相关分析。结果免疫组化显示HSP90α在胰腺癌组织中的阳性率为81.8%(36/144),高于癌旁组织的13.6%(6/44),差异有统计学意义(χ^(2)=19.82,P<0.001)。胰腺癌组织中HSP90α阳性表达与突变型p53阳性表达呈正相关(相关系数为0.57,P<0.001)。胰腺癌组患者(n=55)血浆HSP90α为83.30(48.30,212.00)μg/L,高于正常人(n=119)的37.00(29.20,43.50)μg/L,差异有统计学意义(Z=-7.34,P<0.001)。血浆HSP90α诊断胰腺癌的ROC曲线下面积为0.85(95%CI:0.77~0.92),最佳界值为53.52μg/L,灵敏度为69.1%(38/55),特异度为98.3%(117/119)。HSP90α诊断胰腺癌的ROC曲线下面积高于癌胚抗原、糖类抗原19-9、糖类抗原125。癌组织免疫组化染色HSP90α表达阴性组(n=8)术后1年累积生存率为87.5%,高于阳性组(n=36)的18.8%,差异有统计学意义(χ^(2)=12.74,P<0.001)。结论HSP90α在胰腺癌组织中阳性表达率高,HSP90α阳性表达与突变型p53阳性表达呈正相关。HSP90α表达阳性胰腺癌患者预后较差。HSP90α诊断胰腺癌效果良好,有应用潜力。Objective To analyze the expression of heat shock protein 90α(HSP90α)in pancreatic cancer tissues and its potential diagnostic value for pancreatic cancer.Methods A retrospective study was conducted on surgical specimens and clinical data from 99 patients with pancreatic cancer who were treated at Qingdao Municipal Hospital from January 2018 to May 2023,including 58 males and 41 females,with the age of(63.5±23.5)years.Among them,44 patients(44.4%)were used for pathological examination and prognostic analysis,while 55 patients(55.6%)were tested for plasma HSP90αlevels to evaluate its diagnostic efficacy for pancreatic cancer.Blood samples from 119 healthy individuals undergoing routine physical examinations at the same hospital during the same period were collected,including 74 males and 45 females,with the age of(50.5±25.5)years,and plasma HSP90αlevels were measured.Immunohistochemistry(IHC)was performed to detect the expression of HSP90αin cancerous and adjacent non-cancerous tissues.Receiver operating characteristic(ROC)curve analysis was used to assess the diagnostic performance of HSP90α,carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and carbohydrate antigen 125(CA125)for pancreatic cancer.Survival analysis was conducted using the Kaplan-Meier method,and the log-rank test was used to compare survival rates.The correlation between HSP90αpositive expression in cancer tissues and mutant p53 positive expression was analyzed using Spearman correlation analysis.Results Immunohistochemical analysis showed that the positive expression rate of HSP90αin pancreatic cancer tissues was 81.8%(36/44),higher than that in adjacent non-cancerous tissues 13.6%(6/44)(χ^(2)=19.82,P<0.01).HSP90αpositive expression in pancreatic cancer tissues was positively correlated with mutant p53 positive expression(correlation coefficient was 0.57,P<0.001).The median plasma HSP90αlevel in the pancreatic cancer group(n=55)was 83.30(48.30,212.00)μg/L,which was significantly higher than that in the normal control g

关 键 词：胰腺肿瘤 肿瘤抑制蛋白质P53 热休克蛋白90Α 预后 

分 类 号：R735.9[医药卫生—肿瘤]