The Clinical Significance Of EHsp90α Expression In Malignant Pleural Effusions And Ascites

Objective:To investigate the clinical significance of e Hsp90α expression in malignant pleural effusion and malignant ascites.Methods:80 patients with pleural effusion and 63 patients with ascites were enrolled in the Shaanxi Provincial Tumor Hospital and Shaanxi Provincial People’s Hospital from April 1,2018 to June 1,2018.According to the diagnosis of primary disease,the patients with pleural effusion were divided into benign pleural effusion group and malignant pleural effusion group,and the patients with ascites were divided into benign ascites group and malignant ascites group.The levels of Hsp90α in pleural effusion and ascites were measured by ELISA,at the same time,the levels of LDH in pleural effusion and ascites were collected from clinical departments.Then we compared the levels of Hsp90α in benign pleural effusion with that in malignant pleural effusion.Moreover,we compared the levels of Hsp90α in benign ascites with that in malignant ascites.ROC curves were used to evaluate the diagnostic performance of Hsp90α,LDH and combined diagnosis(Hsp90α+LDH)in pleural effusion and ascites.Finally,we analyzed the correlation between Hsp90α and LDH in malignant pleural effusion and malignan ascites,respectively.Result:1.The patients with malignant pleural effusion mainly included 28 lung cancer(56%)and 6breast cancer(12%).The pulmonary infection is the large primary disease of benign pleural effusion,accounted for 17 patients(56.67%).There was no statistically significant difference in gender between patients with benign pleural effusion group and malignant pleural effusion group(c 2=2.000,P=0.157).The age of patients with malignant pleural effusion group is slightly older than that in benign pleural effusion group [(67.12±14.61)vs(64.90±21.84)year],but there was no statistically significant difference(t=0.494,P=0.624).2.The patients with malignant ascites mainly included 12 ovarian cancer(26.67%),8primary liver cancer(17.78%)and 7 gastric cancer(15.56%).The cirrhosis is the most primary disease of benign ascites,accounted for 14 patients(77.78%).There was no statistically significant difference in gender between patients with benign ascites group and malignant ascites group(c 2=0.006,P=0.936).The age of patients with malignant ascites group is slightly older than that in benign ascites group [(61.02±13.59)vs(58.39±16.75)year],but there was no statistically significant difference(t=0.649,P=0.518).3.The level of Hsp90α in malignant pleural effusion group [187.900(68.683-334.975)]ng/m L was higher than that in benign pleural effusion group [3.905(1.240-44.473)] ng/m L,and there was statistically significant difference(Z=-6.261,P<0.001).The level of Hsp90αin malignant ascites group [150.900(53.528-333.075)] ng/m L was higher than that in benign ascites group [2.075(1.020-5.330)] ng/m L,there was statistically significant difference(Z=-5.683,P<0.001).4.The concentration of LDH in malignant pleural effusion group[302.000(159.000-450.000)] U/L was higher than that in benign pleural effusion group[126.000(103.500-251.000)] U/L,there was statistically significant difference(Z=-2.729,P<0.05).The concentration of LDH in malignant ascites group [188.000(96.500-303.500)]U/L was slightly higher than that in benign ascites group [118.500(43.000-245.000)] U/L,but there was no statistically significant difference(Z=-1.789,P>0.05).5.The ROC curve showed that Hsp90α had an AUC 0.900(95% CI: 0.793-0.963)with a sensitivity of 100% and specificity of 73.33% at the optimum cutoff 16.88 ng/m L in differentiating benign pleural effusion from malignant pleural effusion.Compared with LDH(AUC 0.709,sensitivity 86.21%,specificity 51.57%)in differentiating benign pleural effusion from malignant pleural effusion,there was statistically significant difference(P<0.05).It was shown that,by contrast with combined diagnosis(AUC 0.907,sensitivity96.55%,specificity 79.31%)in differentiating benign pleural effusion from malignant pleural effusion,there was no statistically significant difference(P> 0.05).6.The ROC curve showed that Hsp90α had an AUC 0.951(95% CI: 0.830-0.995)with a sensitivity of 88.64% and specificity of 100% at the optimum cutoff 18.80ng/m L in differentiating benign ascites from malignant ascites.Compared with LDH(AUC 0.693,sensitivity 90%,specificity 52.63%)in differentiating benign ascites from malignant ascites,there was statistically significant difference(P<0.05).It was shown that,by contrast with combined diagnosis(AUC 0.955,sensitivity 85%,specificity 100%)in differentiating benign ascites from malignant ascites,there was no statistically significant difference(P>0.05).7.Correlation analysis showed that Spearman correlation coefficient of Hsp90α and LDH in malignant pleural effusion was 0.592,there was statistically significant difference(P<0.001).In addition,the Spearman correlation coefficient of Hsp90α and LDH in malignant ascites was 0.776,there was statistically significant difference(P<0.001).Conclusions:1.The pleural effusion Hsp90α showed excellent diagnosis performance in differentiating benign pleural effusion from malignant pleural effusion,and ascites Hsp90α also performed excellent diagnosis performance in differentiating benign ascites from malignant ascites.It’s expected to be a new biomarker for the diagnosis of malignant pleural effusion or malignant ascites.2.There is a positive correlation between Hsp90α and LDH in pleural effusion or ascites,which is expected to be an independent factor to forecast therapeutic efficacy and prognosis of malignant pleural effusion or ascites.