目的 探讨血浆热休克蛋白90α（HSP90α）与肝细胞肝癌（HCC）患者经动脉化疗栓塞（TACE）治疗反应及长期预后的关系。 方法 收集2017年8月至2018年12月在中国医学科学院肿瘤医院介入治疗科进行TACE治疗的96例HCC患者的病历资料，采用χ2检验分析TACE治疗前血浆HSP90α水平与临床病理特征的关系，TACE治疗应答的影响因素分析采用单因素和多因素logistic回归分析，TACE治疗后患者无进展生存时间（PFS）的影响因素分析采用单因素和多因素Cox回归分析。 结果 96例患者TACE治疗前的血浆HSP90α水平为（99.70±66.61）ng/ml。高HSP90α组（30例）比低HSP90α组（66例）肿瘤更大、甲胎蛋白更高、血管侵犯阳性者更多、巴塞罗那临床肝癌（BCLC）分期更晚（均P＜0.05）。TACE治疗4周后评估，应答组41例，无应答组55例。应答组与无应答组患者TACE治疗前后HSP90α水平差值分别为（-32.20±22.79）ng/ml和（7.20±51.94）ng/ml，差异有统计学意义（P＜0.001）。多因素logistic回归分析显示，Child-Pugh分级（OR=0.186，P=0.046）、血管侵犯（OR=0.132，P=0.025）、TACE治疗后血浆HSP90α降低百分比（25%～50%：OR=5.061，P=0.013；＞50%：OR=86.831，P＜0.001）是HCC TACE治疗应答的独立影响因素。96例患者的中位PFS为8.7个月。多因素Cox回归分析显示，BCLC分期（B期：HR=2.804，P=0.008；C期：HR=4.628，P＜0.001）和TACE治疗后血浆HSP90α降低百分比（25%～50%：HR=0.569，P=0.051；＞50%：HR=0.198，P＜0.001）是TACE治疗后HCC患者PFS的独立影响因素。 结论 血浆HSP90α作为一种新的生物标志物，可用于预测HCC患者TACE治疗的疗效和预后。 Objective To evaluate the relationship between plasma heat shock protein 90α (HSP90α) levels and treatment response after four weeks and long-term prognosis after transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Methods The clinical data of HCC patients who underwent TACE in the Department of Interventional Radiology, Cancer Hospital of Chinese Academy of Medical Sciences from August 2017 to December 2018 were retrospectively collected. Chi-square tests were used to analyze the relationship between plasma HSP90α level and clinicopathological features before TACE treatment. Univariate and multivariate logistic regression analysis was used to analyze the influencing factors of TACE treatment response. Univariate and multivariate Cox regression analysis was used to analyze the influencing factors of progression-free survival (PFS) after TACE treatment. Results The expression level of plasma HSP90α in 96 patients before TACE treatment was (99.70 ± 66.61) ng/ml. Compared with the low HSP90α group (n=66), the high HSP90α group (n=30) had larger tumors, higher alpha-fetoprotein enrichment, more positive vascular invasions, and more advanced Barcelona Clinic Liver Cancer (BCLC) stages (all P<0.05). After four weeks of TACE treatment, 41 patients in the response group and 55 patients in the non-response group were evaluated. The difference of HSP90α expression levels between the response group and the non-response group before and after TACE treatment was (-32.20±22.79) ng/ml and (7.20±51.94) ng/ml, respectively, and the difference was statistically significant (P<0.001). Multivariate logistic regression analysis showed that Child-Pugh classification (OR=0.186, P=0.046), vascular invasion (OR=0.132, P=0.025), and the percentage reduction of plasma HSP90α after TACE treatment (percentage reduction 25%-50%: OR=5.061, P=0.013 percentage reduction >50%: OR= 86.831, P<0.001) were independent influencing factors for the response to TACE treatment in HCC. The median PFS of the 96 patients was 8.7 months. Multivariate Cox regression analysis showed that BCLC stage (stage B:HR=2.804, P=0.008 stage C: HR=4.628, P<0.001) and the percentage reduction of plasma HSP90α after TACE treatment (percentage reduction 25%-50%:HR=0.569, P=0.051 percentage reduction >50%: HR=0.198, P<0.001) were independent influence factors for the PFS in these HCC patients after TACE treatment. Conclusion Plasma HSP90α may represent a novel biomarker for predicting efficacy of TACE and PFS of patients with HCC.
The clinical value of heat shock protein 90α in predicting the prognosis of interventional therapy for hepatocellular carcinoma
Objective To evaluate the relationship between plasma heat shock protein 90α (HSP90α) levels and treatment response after four weeks and long-term prognosis after transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Methods The clinical data of HCC patients who underwent TACE in the Department of Interventional Radiology, Cancer Hospital of Chinese Academy of Medical Sciences from August 2017 to December 2018 were retrospectively collected. Chi-square tests were used to analyze the relationship between plasma HSP90α level and clinicopathological features before TACE treatment. Univariate and multivariate logistic regression analysis was used to analyze the influencing factors of TACE treatment response. Univariate and multivariate Cox regression analysis was used to analyze the influencing factors of progression-free survival (PFS) after TACE treatment. Results The expression level of plasma HSP90α in 96 patients before TACE treatment was (99.70 ± 66.61) ng/ml. Compared with the low HSP90α group (n=66), the high HSP90α group (n=30) had larger tumors, higher alpha-fetoprotein enrichment, more positive vascular invasions, and more advanced Barcelona Clinic Liver Cancer (BCLC) stages (all P<0.05). After four weeks of TACE treatment, 41 patients in the response group and 55 patients in the non-response group were evaluated. The difference of HSP90α expression levels between the response group and the non-response group before and after TACE treatment was (-32.20±22.79) ng/ml and (7.20±51.94) ng/ml, respectively, and the difference was statistically significant (P<0.001). Multivariate logistic regression analysis showed that Child-Pugh classification (OR=0.186, P=0.046), vascular invasion (OR=0.132, P=0.025), and the percentage reduction of plasma HSP90α after TACE treatment (percentage reduction 25%-50%: OR=5.061, P=0.013 percentage reduction >50%: OR= 86.831, P<0.001) were independent influencing factors for the response to TACE treatment in HCC. The median PFS of the 96 patients was 8.7 months. Multivariate Cox regression analysis showed that BCLC stage (stage B:HR=2.804, P=0.008 stage C: HR=4.628, P<0.001) and the percentage reduction of plasma HSP90α after TACE treatment (percentage reduction 25%-50%:HR=0.569, P=0.051 percentage reduction >50%: HR=0.198, P<0.001) were independent influence factors for the PFS in these HCC patients after TACE treatment. Conclusion Plasma HSP90α may represent a novel biomarker for predicting efficacy of TACE and PFS of patients with HCC.
Hepatocellular carcinomaTransarterial chemoembolizatonHeat shock protein 90αTumor responsePrognosis
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