BACKGROUND Hepatocellular carcinoma (HCC) is a major health problem worldwide. However, the popular tumor marker, AFP, lacks sensitivity although its specificity is high. Tissue biopsy is an invasive operation and may increase the risk of needle-track metastases. Heat shock protein 90 (HSP90) is a potential biomarker for tumor diagnosis and prognosis. This study aims to determine whether levels of plasma HSP90α in HCC patients can be used as a cost-effective and simple test for the initial diagnosis of the disease. METHODS Plasma samples were collected from 659 HCC patients, 114 secondary hepatic carcinoma (SHC) patients, 28 hepatic hemangioma patients and 230 healthy donors. The levels of HSP90α were measured by ELISA. RESULTS The levels of plasma HSP90α in HCC patients were significantly higher than in healthy donors and in patients with hepatic hemangioma or SHC (144.08 ± 4.98, 46.81 ± 1.11, 61.56 ± 8.20 and 111.96 ± 10.08 ng/mL, respectively; p < 0.05 in all cases). The levels were associated with age (p = 0.001), BCLC stage (p < 0.001), levels of AFP (p < 0.001), tumor size (p < 0.001), tumor number (p < 0.001), PVTT (p < 0.001), EHM (p < 0.001) and Child-Pugh stage in the HCC cohort. In addition, the levels of plasma HSP90α showed an upward trend along with the progression of the BCLC stage. ROC curve analysis showed that compared to AFP (AUC 0.922, 95%CI 0.902-0.938) or HSP90α (AUC 0.836, 95%CI 0.810-0.860), the combination of HSP90α and AFP (AUC0.943, 95%CI 0.925-0.957) significantly improved the diagnostic efficiency for HCC patients. CONCLUSION The results suggest that plasma Hsp90 α levels can be used as an initial diagnosis for patients with HCC in both rural and cosmopolitan settings.

中文翻译：

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血浆HSP90α水平对检测肝细胞癌的诊断价值。

背景技术肝细胞癌（HCC）是世界范围内的主要健康问题。但是，流行的肿瘤标志物AFP虽然特异性很高，但缺乏敏感性。组织活检是一项侵入性手术，可能会增加发生针迹转移的风险。热休克蛋白90（HSP90）是用于肿瘤诊断和预后的潜在生物标志物。这项研究旨在确定HCC患者血浆HSP90α的水平是否可以用作该疾病的初始诊断的经济有效且简单的测试。方法从659例HCC患者，114例继发性肝癌（SHC）患者，28例肝血管瘤患者和230名健康供体中收集血浆样品。通过ELISA测量HSP90α的水平。结果HCC患者的血浆HSP90α水平显着高于健康供体和肝血管瘤或SHC患者（分别为144.08±4.98、46.81±1.11、61.56±8.20和111.96±10.08 ng / mL; p <0.05所有情况）。这些水平与年龄（p = 0.001），BCLC分期（p <0.001），AFP水平（p <0.001），肿瘤大小（p <0.001），肿瘤数目（p <0.001），PVTT（p <0.001）相关），EHM（p <0.001）和HCC队列中的Child-Pugh阶段。另外，血浆HSP90α的水平随着BCLC阶段的进展而呈上升趋势。ROC曲线分析显示，与AFP（AUC 0.922，95％CI 0.902-0.938）或HSP90α（AUC 0.836，95％CI 0.810-0.860）相比，HSP90α和AFP（AUC0.943，95％CI 0.925-0）的组合。957）大大提高了HCC患者的诊断效率。结论结果表明，血浆Hsp90α水平可作为农村和国际化环境中HCC患者的初步诊断。