热休克蛋白90α在肺癌胸腔积液中的表达及其对胸腔热灌注化疗疗效的影响

摘要

目的 对比热休克蛋白90α(HSP90α)在肺癌胸腔积液及良性胸腔积液中的表达,并分析胸腔循环热灌注化疗前后HSP90α在胸腔积液中表达的变化以及其对疗效的影响.方法 应用酶联免疫吸附试验测定HSP90α在53例肺癌胸腔积液和30例良性胸腔积液患者积液中的表达,观察其表达的差异.在胸腔循环热灌注化疗治疗肺癌胸腔积液前及治疗后72 h观察HSP90α在胸腔积液中表达的变化(治疗周期数为1～5次,平均2.3次),并分析其与疗效的关系.结果 肺癌胸腔积液中HSP90α的表达[(80±34)μg/L]较良性胸腔积液[(31±13)μg/L]高,差异有统计学意义(t=56.400,P＜0.01).行胸腔循环热灌注化疗后HSP90α表达水平为(93±32) μg/L,较治疗前增高(t=3.152,P＜0.01),治疗后HSP90α/治疗前HSP90α比值与疗效呈负相关(r=-0.291,P＜0.05).治疗后HSPg0α/治疗前HSP90α＜1.0者中位胸腔积液进展时间为4.3个月,比值1～1.5者为2.3个月,比值>1.5者为1.8个月.结论 HSP90α在肺癌胸腔积液中表达增高,行胸腔热灌注化疗后在胸腔积液中表达升高.热灌注化疗后胸腔积液中HSP90α越低疗效越好,可作为肺癌胸腔积液治疗中的疗效评价指标.%Objective To compare the expression of heat shock protein 90α (HSP90α) in malignant pleural effusion (MPE) and its predictive value on effect of hyperthermic pleural perfusion with chemotherapy drug in lung cancer.Methods The expression of HSP90α in malignant pleural effusion of 53 patients with lung cancer and benign pleural effusion of 30 patients were detected and compared using enzyme-linked immunosorbent assay kits.The patients of lung cancer reveived intrapleural hypothermic perfusion with cisplatin for 1-5 times (average 2.3 times).Before and after treatment,the expression of HSP90α in pleural effusion was measured and its correlation with efficacy was analyzed.Results The expression level of HSP90α in MPE was significantly higher than that in benign pleural effusion [(80 ± 34) μg/L vs (31 ± 13) μg/L] (t =56.4,P ＜ 0.01).After treatement,the HSP90α level was significantly increased compared with that before treatment [(93 ± 32) μg/L vs (80 ± 34) μg/L] (t =3.152,P ＜0.01).The ratio of posttreatment/pretreatment HSP90α was negatively correlated with the curative effect (r =-0.291,P ＜0.05).The median progression time of MPE was 4.3 months in patients with ratio of posttreatment/pretreatment HSP90α ＜ 1,and was 2.3 months in patients with ratio 1-1.5,was 1.8 months in patients with ratio ＞ 1.5.Conclusions HSP90α is highly expressed in MPE of patients with lung cancer;after intrapleural hypothermic perfusion with chemotherapy drug,the expression level of HSP90αin MPE is increased;the HSP90α level in MPE after treatment is negatively correlated with curative effect,and can be used as a predictor of efficacy.