Background: Heat shock protein 90α (Hsp90α) is considered a tumor biomarker in many human malignancies. This study investigated the diagnostic value of Hsp90α combined with other traditional lung cancer biomarkers (CEA, CYFRA21-1, and NSE) and its role in monitoring the treatment response of lung cancer patients.
Methods: A total of 205 patients with lung cancer and 186 patients with lung benign disease who were admitted to our hospital were enrolled from 2018 to 2020. The 205 patients included 76 cases of squamous, 92 cases of adenocarcinoma, and 37 cases of small cell lung cancer. There were 49 patients with TNM I+II and 156 patients with TNM III+IV. A total of 10 mL baseline peripheral venous blood samples and subsequent peripheral venous blood samples (7 days after two cycles of chemotherapy) were collected, and the levels of Hsp90α, carcinoembryonic antigen (CEA), Cytokeratin 19 fragments (CYFRA21-1), and neuron-specific enolase (NSE) were detected by ELISA kit.
Results: Hsp90α was obviously higher in serum from patients with lung cancer than in patients with benign lung disease (p < 0.0001). Moreover, Hsp90α levels were higher in patients with advanced-stage (stage III-IV) lung cancer compared to those with early-stage (stage I-II). Hsp90α level was significantly decreased following treatment with chemotherapy in the progress partial response group (p = 0.017), whereas the level of Hsp90α was significantly higher after chemotherapy treatment in the progressive disease group (p < 0.0001). In addition, compared with CYFRA21-1, CEA, or NSE alone, the AUC of Hsp90α combined with CYFRA21-1, CEA, or NSE were significantly higher in the diagnosis of adenocarcinoma or small-cell lung cancer.
Discussion: Hsp90α combined with CYFRA21-1, CEA, and NSE can be used as diagnostic indicators of lung cancer. The Hsp90α level can be used to monitor treatment response.
Keywords: CEA; CYFRA21-1; Heat shock protein 90α; NSE; lung cancer.