| Background Colorectal cancer(CRC)is one of the most common human malignant tumors,and its incidence increases with age.CRC has limitations,with or without peripheral lymph node invasion.Clinically,different treatment methods are selected according to the location,invasion and metastasis of the lesion.Surgical resection is the first choice for patients with early stage CRC,while adjuvant or neoadjuvant chemotherapy(or radiotherapy)is often needed for patients with late stage CRC.Therefore,the rational choice of radical surgery,radiotherapy and chemotherapy is the key to the effective treatment of CRC.Some CRC patients can be cured by reasonable treatment,but some patients have distant metastasis when they are found,or have recurrence and metastasis after surgery,which is difficult to cure.With the continuous progress of chemotherapy,radiotherapy,targeted therapy,immunotherapy and other technologies and the application of comprehensive treatment,the treatment effect,quality of life and survival time of patients with advanced CRC have been greatly improved.Rational evaluation of treatment response is one of the key steps in the selection of treatment options.CT,MRI,PET-CT and other imaging examinations are important methods for efficacy evaluation,but their application is limited because of radiation or price.At present,tumor markers such as carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 12-5(CA12-5)and carbohydrate antigen 19-9(CA19-9)are routinely used in the evaluation of CRC,which have the advantages of simple operation and high patient cooperation.However,the sensitivity and specificity of conventional tumor markers are still low.Therefore,it is of great significance to find a blood marker with higher sensitivity,specificity and more convenient detection in clinical practice,which can be used in combination with conventional tumor markers to further predict the recurrence and progression of CRC and evaluate the efficacy.It has been shown that HSP90α is a chaperone involved in the angiogenesis,proliferation,invasion and migration of cancer cells.CD4+ CD25+Treg can inhibit the anti-tumor response in vivo,which is closely related to tumor immune escape.Some studies have suggested that serum HSP90α and CD4+CD25+Treg are involved in the development of gastrointestinal tumors,and have a certain correlation with the prognosis of liver cancer and gastric cancer,and both can have high levels in patients with CRC.Although the relationship between serum HSP90α and CD4+CD25+Treg and the therapeutic effect of CRC is not conclusive,the results are still worthy of expectation.The aim of this study is to investigate the possibility of serum HSP90α and CD4+CD25+Treg as indicators for dynamic monitoring the efficacy of advanced CRC treatment by reviewing the clinical data of patients with advanced CRC in our hospital.Objective To analyze the relationship between serum HSP90α,CD4+CD25+Treg and the efficacy of advanced colorectal cancer.Methods The clinical data of 61 patients with colorectal cancer treated in Chaohu Hospital Affiliated to An Hui Medical University from January 2020 to December 2021 were retrospectively analyzed.Before chemotherapy,HSP90α and CD4+CD25+Treg were detected,and CEA,CA19-9,CA72-4,CA12-5 were detected.The changes of serum HSP90α,CD4+CD25+Treg and tumor markers before and after chemotherapy were compared.Results There was no significant correlation between serum HSP90α,CD4+CD25+Treg and gender,age,tumor location and differentiation degree(all P >0.05).The levels of serum HSP90α,CD4+CD25+Treg and CEA in patients with colorectal cancer after treatment were lower than those before treatment,while CA19-9,CA72-4 and CA12-5 were slightly higher in some patients.The levels of HSP90α(t=2.092,P=0.041),CD4+CD25+Treg(t=2.018,P=0.048),CEA(t=2.046,P=0.045)were significantly different(all P < 0.05),while there was no significant difference in the levels of CA19-9(t=1.803,P=0.076),CA72-4(t=1.598,P=0.115)and CA12-5(t=1.697,P=0.095)(all P > 0.05).After treatment,the serum levels of HSP90α,CD4+CD25+Treg and CEA in patients with effective chemotherapy were lower than those before treatment,and CA19-9,CA72-4 and CA12-5 in some patients were higher than those before treatment.The levels of HSP90α(t=2.313,P=0.026),CD4+CD25+Treg(t=2.395,P=0.022),CEA(t=2.095,P=0.043)were statistically different(all P < 0.05),while there was no significant difference in CA19-9,CA72-4 and CA12-5(all P > 0.05).There was also no significant difference in the levels of serum HSP90α,CD4+CD25+Treg,CEA,CA19-9,CA72-4 and CA12-5 after treatment in patients who failed to respond to chemotherapy(all P > 0.05).Conclusion The levels of serum HSP90α and CD4+CD25+ Treg are correlated with the curative effect of advanced colorectal cancer,which provides a reference value for dynamic evaluation of the curative effect of advanced colorectal cancer. |
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