摘要
目的 探讨血清中热休克蛋白90α(heat shock protein 90 alpha,HSP90α)、血管内皮生长因子(vascular endothelial growth factor,VEGF)在非小细胞肺癌患者中的表达及预后价值。方法 选取NSCLC患者120例作为NSCLC组,同期收治肺良性疾病患者30例作为非NSCLC组,同期健康体检者30例作为对照组,采用酶联免疫吸附法(ELISA)检测血清HSP90α、VEGF水平,多因素Cox比例风险回归模型分析预后影响因素,ROC曲线分析血清HSP90α、VEGF及联合检测的预测价值。结果 三组血清HSP90α、VEGF水平比较差异显著(P<0.05),其中NSCLC组血清HSP90α、VEGF水平最高,非NSCLC组次之,对照组最低;不同淋巴结转移、肿瘤分期患者血清HSP90α、VEGF水平比较差异显著(P<0.05),不同性别、年龄、病理类型、病理分级、肿瘤大小患者比较差异不显著(P>0.05);HSP90α高表达组与低表达组3年总体生存率分别为59.42%(41/69)、85.11%(40/47),2组比较,差异有统计学意义(log Rankχ^(2)=9.710,P=0.002);VEGF高表达组与低表达组3年总体生存率分别为69.86%(51/73)、85.71%(30/35),2组比较,差异有统计学意义(log Rankχ^(2)=3.880,P=0.049);多因素Cox比例风险回归显示,淋巴结转移(OR=2.642,95%CI:1.148~6.108)、肿瘤分期Ⅲ期(OR=1.613,95%CI:1.008~2.517)、HSP90α高表达(OR=2.521,95%CI:1.241~4.579)、VEGF高表达(OR=2.554,95%CI:1.365~5.836)为肺癌患者预后死亡的危险因素(P<0.05);ROC曲线显示,血清HSP90α、VEGF联合预测预后的效能更高,AUC为0.887,灵敏度为0.926,特异度为0.753,95%CI为0.793~0.981。结论 淋巴结转移、肿瘤分期、HSP90α和VEGF高表达被确认为影响肺癌患者预后的不良因素,联合检测HSP90α和VEGF有望提高非小细胞肺癌患者预后评估的准确度和效能。
Objective To investigate the expression and prognostic value of serum heat shock protein 90 alpha(HSP90α)and vascular endothelial growth factor(VEGF)in patients with non-small cell lung cancer.Methods A total of 120 patients with NSCLC were selected as the NSCLC group,30 patients with benign lung diseases were selected as the non-NSCLC group,and 30 healthy subjects were selected as the control group.Serum HSP90αand VEGF levels were detected by enzyme-linked immunosorbent assay(ELISA),and the prognostic factors of patients were determined by Cox proportional risk regression model.ROC curve analysis of serum HSP90α,VEGF and the predictive value of combined detection.Results There were significant differences in serum HSP90αand VEGF levels among the three groups(P<0.05).The serum HSP90αand VEGF levels in NSCLC group were the highest,followed by non-NSCLC group,and the lowest in control group.There were significant differences in serum HSP90αand VEGF levels among patients with different lymph node metastasis and tumor stage(P<0.05),but there were no significant differences among patients with different sex,age,pathological type,pathological grade and tumor size(P>0.05).The 3-year overall survival rates of HSP90αhigh expression group and low expression group were 59.42%(41/69)and 85.11%(40/47),respectively,and the difference between the 2 groups was statistically significant(log Rank χ^(2)=9.710,P=0.002).The 3-year overall survival rates of high and low VEGF expression groups were 69.86%(51/73)and 85.71%(30/35),respectively,and the difference between the 2 groups was statistically significant(log Rank χ^(2)=3.880,P=0.049).Multivariate Cox proportional hazard regression showed that lymph node metastasis(OR=2.642,95%CI:1.148~6.108),tumor stageⅢ(OR=1.613,95%CI:1.008~2.517),high expression of HSP90α(OR=2.521,95%CI:1.241~4.579)and high expression of V-EGF(OR=2.554,95%CI:1.365~5.836)were risk factors for prognostic death in lung cancer patients(P<0.05).ROC curve showed that serum HSP90αand VEGF combined had higher prognostic efficacy,with AUC of 0.887,sensitivity of 0.926,specificity of 0.753 and 95%CI of 0.793~0.981.Conclusion Lymph node metastasis,tumor stage,high expression of HSP90αand VEGF are confirmed as poor prognostic factors of NSCLC patients.Combined detection of HSP90αand VEGF is expected to improve the accuracy and efficiency of prognosis evaluation of NSCLC patients.
作者
姚晓燕
李醒亚
徐巧巧
YAO Xiaoyan;LI Xingya;XU Qiaoqiao(Zhengzhou University First Affiliated Hospital,Zhengzhou,450000)
出处
《实用癌症杂志》
2025年第7期1049-1053,1058,共6页
The Practical Journal of Cancer
关键词
非小细胞肺癌
热休克蛋白90Α
血管内皮生长因子
预后
Non-small cell lung cancer
Heat shock protein 90 alpha
Vascular endothelial growth factor
The prognosis
