A Study On The Expression Characteristics Of Heat Shock Protein 70 In Hepatitis B,Cirrhosis And Hepatocellular Carcinoma

Background:Hepatocellular carcinoma?HCC?is the 6^th most common malignant tumor in the world with the 4^th highest mortality rate.The incidence of HCC in East Asian men and women are the 1^st and 2^nd in the world.The early symptoms are not notable while the degree of malignancy is high.The first diagnosis is often in the advanced stages,while the surgical resection rate is less than 15%,and willingness of patients to undergo surgical treatment are less than 20%.Therefore,early diagnosis and early treatment is particularly important for improving the prognosis of patients with liver cancer.Alpha-fetoprotein?AFP?is the main marker for screening hepatocellular carcinoma.However,patients with low concentrations of alpha-fetoprotein often missed diagnosis and misdiagnosis as space occupying lesion?SQL?because they could not be detected effectively.Combined diagnosis of common tumor markers for primary hepatocellular carcinoma is an effective attempt,such as AFP,AFP-L3,PIVKA-II and GPC-3,and it is not easy to be accepted by patients because of the high cost of testing.The study found that heat shock protein70?HSP 70?is involved in tumorigenesis and development,but there is no correlation between serum and body fluid specimens.Objective:To study the expression and diagnostic efficacy of heat shock protein 70?HSP 70?in blood and urine samples of healthy people,chronic hepatitis B,hepatitis B cirrhosis and primary hepatocellular carcinoma.Methods:?1?Enzyme-linked immunosorbent assay?ELISA?was used to detect the expression levels of blood and urine samples with 25 healthy subjects,24 patients with chronic hepatitis B,18 patients with hepatitis B cirrhosis and 23 patients with hepatitis B-related primary Hepatic Carcinoma.Analyze results,calculate the sensitivities and specificities,and determine the diagnostic threshold with the receiver operating characteristic curve?ROC?curve.?2?Western-Blot was used to detect the expression of HSP 70 in peripheral venous blood mononuclear cells?PBMC?of 6 healthy subjects,6 chronic hepatitis B patients,6 patients with hepatitis B cirrhosis and 6patients with hepatitis B-related primary hepatocellular carcinoma,and to further analyze the expression characteristics of HSP 70 in PBMC.Results:?1?The serum HSP 70 level in HCC group was obviously higher than that in healthy controls?P<0.001?.The overall comparison has obvious differences?Chi-square value=35.57,P<0.001?.And there was significant difference between HCC group and healthy control group?P<0.001?.The area under the ROC curve of serum HSP 70 for diagnosis of HCC was 0.811.When the serum HSP 70 content was 171.50pg/ml,the Yoden index reached the maximum,which was 0.594.The sensitivity and specificity for diagnosis of HCC were 0.714 and 0.880,respectively.The expression of serum HSP 70 was the highest in patients with chronic hepatitis B,and gradually decreased with the progress of the disease.?2?The level of HSP 70 in urine of HCC group was significantly lower than that of healthy controls?P<0.001?.The overall comparison has obvious differences?Chi-square value=47.58,P<0.001?.And there was significant difference between HCC group and healthy control group?P<0.001?.The area under ROC curve of HSP70 in urine for diagnosis of HCC was AUC=0.029<0.5,which had unsatisfying predictive value.?3?The area under ROC curve of HSP 70 blood/urine ratio for diagnosis of HCC was 0.934.When the ratio of serum HSP 70 to urine HSP 70 was 2.55,the Yoden index reached the maximum of 0.706.The sensitivity and specificity for diagnosis of HCC were 0.786 and 0.920,respectively.?4?The expression of HSP 70 in PBMC of patients with hepatitis B cirrhosis and liver cancer was higher than that of normal control group and chronic hepatitis B group?P<0.05?.There was significant difference between the two groups?F=54.52,P<0.001?.Conclusion:?1?The expression of HSP 70 in serum of HCC patients was significantly increased,which had satisfying sensitivity and specificity.?2?The expression of HSP 70 in the urine of patients with HCC was significantly decreased,and it showed good predictive value when using HSP 70 blood/urine ratio combined with serum.?3?The expression of HSP 70 in PBMC of patients with hepatitis B cirrhosis and liver cancer is significantly increased,and relative to the stage of pathological progression.