The Clinical Significance Of Plasma HSP90α And Serum CEA, CA19-9Ecpression In Colorectal Cancer

BackgroundThe90kDa heat shock protein(HSP90）is a highly evolutionarily conserved molecularchaperone,comprising1-3%of total cellular proteins under non-stress conditions. There aretwo major cytoplasmic isoforms of Hsp90, HSP90α and HSP90β.HSP90α is induced uponexposure to stress,while HSP90β is constitutively active and is considered as a housekeepingchaperone. A growing number of studies have shown that HSP90α could be secreted by manykinds of cells,including cancer cells.Secreted HSP90α should pomote cancer cell migrationand invasion.Recent studies have found that secreted HSP90α should be detected in theplasma of cancer patients,and the level of HSP90α in cancer patients were significantly higherthan those of normal volunteers,the level of plasma HSP90α is positively correlated withtumor malignancy and it may be a potential diagnostic and prognostic marker in clinic.But todate,there is no large well-designed study about the diagnostic value of secreted Hsp90αincolorectal cancer.ObjectiveTo investigate the diagnostic value of the plasma HSP90α in colorectal cancer, and the clinical significance of HSP90α,CEA, CA19-9expression in colorectal cancer.MethodsFasting morning venous blood samples were collected from102colorectal cancer patientsdiagnosed in Shandong Tumor Hospital from August2012to July2013.120normal subjectswere selected as a control group. All patients proved to have colorectal carcinoma by biopsyand. The level of serum CEA and CA19-9in cancer patients were tested by electrochemicalluminescence determination. and the enzyme-linked immunosorbent assay (ELISA) wasapplied to detect the level of the plasma HSP90α.The diagnosis value of plasma HSP90αwere assessed by ROC analysis.the relationship of the three tumor markers withclinicopathological factors were also analyzed. Statistical analysis was performed usingSPSS17.0software，where P value of <0.05were considered significant.Results1. The expression level of HSP90α was significantly upregulated in the plasma ofcolorectal cancer patients compared with the control group,P<0.001.2. The ROC cure indicated that the sensitivity,specificity and AUC value of HSP90αwas78.4%,94.0%and0.915,respectively.3. There was no Statistical significance between the expression level of plasma HSP90αand all the clinicopathological factors analyzed in this study (all P>0.05).4. The positive rate of the plasma HSP90α was significantly higher than those of CEAand CA19-9in colorectal cancer patients (all P<0.001).5. The level of plasma HSP90α of the colorectal cancer patients had no significantlydecrease after surgery (all P>0.05).6. NO Statistical significance between the expression level of CA19-9and the gender,age, tumor histologic grade,smoking history and drinking history,was found.7. NO Statistical significance between the expression level of CEA and the gender, age,tumor histologic grade,drinking history,was found.The serum CEA level of colorectal cance patients with smoking history is higher than that of patients who do not smoke, P=0.017.8. The levels of the serum CEA and CA19-9in colorectal cancer patients were related tothe TNM staging, depth of tumor invasion,lymph node metastasis,lesion location and the sizeof primary tumor(all P<0.05).9. Positivity for both CEA and CA19-9was observed to be more common in colorectalcancer patients who were in TNM grade Ⅲ and Ⅳ and the difference was statisticallysignificant(P<0.05)Conclusions1. The level of plasma HSP90α should be used in adujuvant diagnosing for colorectalcancer, the sensitivity, specificity and AUC value of HSP90α was78.4%,94.0%and0.915,respectively.2. There was no Statistical significance between the expression level of plasma HSP90αand the gender,age,lesion location,TNM staging,depth of tumor invasion,lymph nodemetastasis and tumor histologic grade.The level of plasma HSP90α cannot be used to predictthe prognosis of colorectal cancer.3. The level of plasma HSP90α of the colorectal cancer patients had no significantlydecrease after surgery,and it may be cannot be used in evaluating the effect of the surgery.4. The levels of the serum CEA and CA19-9in colorectal cancer patients were related tothe TNM staging, depth of tumor invasion, lymph node metastasis, lesion location and thesize of primary tumor,it is of certain guiding significance on prognosis.5. Positive levels of both CEA and CA19-9can be considered to indicate an advancedstage in colorectal cancer patients.