热休克蛋白 90α 是肝细胞癌有潜力的预后和预测生物标志物：一项大规模多中心研究。
Heat-shock protein 90α is a potential prognostic and predictive biomarker in hepatocellular carcinoma: a large-scale and multicenter study.
机构信息
Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Luzhou, 46000, Sichuan, China.
Clinical Skills Center, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
出版信息
Hepatol Int. 2022 Oct;16(5):1208-1219. doi: 10.1007/s12072-022-10391-y. Epub 2022 Aug 16.
BACKGROUND
Although the diagnostic value of plasma heat-shock protein 90α (HSP90α) in hepatocellular carcinoma (HCC) has been previously reported, the causal effect of the plasma HSP90α levels on HCC prognosis remains largely unclear. To this extent, we sought to assess whether the plasma HSP90α acts as a prognostic factor for HCC patients.
METHODS
A total of 2150 HCC patients were included in this retrospective study between August 2016 and July 2021. Plasma HSP90α levels were tested within a week before treatment and their association with prognosis was assessed.
RESULTS
An optimal cutoff value of 143.5 for the HSP90α based on the overall survival (OS) was determined using the X-tile software. HCC patients with HSP90α < 143.5 ng/mL (low HSP90α) before and after propensity score matching (PSM) indicated longer median OS (mOS) relative to those with HSP90α ≥ 143.5 ng/mL (high HSP90α) (37.0 vs. 9.0 months, p < 0.001; 19.2 vs. 9.6 months, p < 0.001; respectively). In addition, the high HSP90α plasma level is an independent poor prognostic factor for OS in HCC patients. In our subgroup analysis, including the supportive care group, surgery group, transarterial chemoembolization (TACE) group, adjuvant TACE group, an immune checkpoint inhibitor (ICI) plus targeted therapy group, and TACE plus ICI group, the high HSP90α group demonstrated better OS compared to the low HSP90α group. Moreover, in the supportive care, TACE, ICI plus targeted therapy, TACE plus ICI groups, and high HSP90α levels were also an independent poor prognostic factors for OS.
CONCLUSIONS
Our study confirmed that the plasma HSP90α level can be used as a prognostic biomarker for HCC.
背景
尽管血浆热休克蛋白 90α（HSP90α）在肝细胞癌（HCC）中的诊断价值已被先前报道，但血浆 HSP90α 水平对 HCC 预后的因果影响在很大程度上仍不清楚。在这方面，我们试图评估血浆 HSP90α 是否可作为 HCC 患者的预后因素。
方法
本回顾性研究纳入了 2016 年 8 月至 2021 年 7 月期间的 2150 例 HCC 患者。在治疗前一周内检测血浆 HSP90α 水平，并评估其与预后的关系。
结果
使用 X-tile 软件确定 HSP90α 基于总生存（OS）的最佳截断值为 143.5ng/mL。在倾向评分匹配（PSM）前后，HSP90α<143.5ng/mL（低 HSP90α）的 HCC 患者的中位 OS（mOS）明显长于 HSP90α≥143.5ng/mL（高 HSP90α）的患者（37.0 与 9.0 个月，p<0.001；19.2 与 9.6 个月，p<0.001）。此外，高 HSP90α 血浆水平是 HCC 患者 OS 的独立不良预后因素。在我们的亚组分析中，包括支持治疗组、手术组、经动脉化疗栓塞（TACE）组、辅助 TACE 组、免疫检查点抑制剂（ICI）联合靶向治疗组和 TACE 联合 ICI 组，高 HSP90α 组的 OS 优于低 HSP90α 组。此外，在支持治疗、TACE、ICI 联合靶向治疗、TACE 联合 ICI 组中，高 HSP90α 水平也是 OS 的独立不良预后因素。
结论
我们的研究证实，血浆 HSP90α 水平可用作 HCC 的预后生物标志物。
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