Abstract:

Objective To explore the application value of serum heat shock protein 90α (Hsp90α) combined with β2-microglobulin (β2-MG) detection in the early diagnosis and prognosis of colorectal cancer (CRC). Methods A total of 101 patients with CRC who received their first treatment were selected as the CRC group (no surgery, radiotherapy or chemotherapy before enrollment), 100 patients with benign colon tumor admitted to our hospital during the same period were selected as the benign tumor group and 94 healthy individuals who underwent physical examinations in our hospital were used as the control group. The levels of serum Hsp90α and β2-MG in all subjects were detected by ELISA. Follow-up was conducted every three months within the first two years after surgery, and every six months in the third year, for a total follow-up period of 3 years, and the survival status of CRC patients within 3 years was recorded. ROC curve analysis was used to evaluate the diagnostic value of serum Hsp90α and β2-MG for CRC. The Kaplan-Meier method was used to draw the survival curves of CRC patients with different expression levels of Hsp90α and β2-MG. Results The serum levels of Hsp90α and β2-MG increased successively in the control group, the benign tumor group and the CRC group (P<0.05). There were no significant differences in serum levels of Hsp90α and β2-MG between CRC patients of different genders, ages and lesion locations. The levels of serum Hsp90α and β2-MG in patients with tumor diameter > 5 cm, low differentiation degree, TNM stage Ⅲ and lymph node metastasis were higher than those in patients with tumor diameter ≤ 5 cm, moderate to high differentiation degree, TNM stage Ⅰ-Ⅱ and no lymph node metastasis (P<0.05). The ROC results showed that the combined diagnostic efficacy of serum Hsp90α and β2-MG was superior to that of serum Hsp90α or β2-MG alone (Z = 2.433, 2.435, P<0.05). Based on the average expression levels of serum Hsp90α and β2-MG in CRC patients (76.66 μg/L and 6.52 μg/L), patients were divided into the high expression group of Hsp90α (59 cases), the low expression group of Hsp90α (42 cases), the high expression group of β2-MG (63 cases) and the low expression group of β2-MG (38 cases). Among the 101 CRC patients, 31 died and 70 survived, with a total survival rate of 69.31%. The Kaplan-Meier survival curve showed that the 3-year survival rates of patients with high expression levels of Hsp90α and β2-MG were lower than theose of patients with low expression levels of Hsp90α and β2-MG (P<0.01). Conclusion The expression levels of serum Hsp90α and β2-MG are both elevated in CRC patients, and they are closely related to the occurrence, development and prognosis of CRC.

Key words: colorectal neoplasms, HSP90 heat-shock proteins, beta 2-microglobulin, prognosis, early diagnosis