Diagnostic and prognostic value of heat shock protein 90 alpha in malignant melanoma

摘要

Malignant melanoma is one of the most common tumours of the skin. Heat shock protein 90 alpha (HSP90 alpha) has been applied in the auxiliary diagnosis of various malignancies, as a tumour marker. This study aims to evaluate diagnostic, therapeutic efficacy and prognostic value of plasma HSP90 alpha levels in malignant melanoma. In this study, higher plasma HSP90 alpha levels and abnormal rates were found in malignant melanoma patients than in healthy controls (92.63 vs. 51.84 ng/mL; P 4 mm, a high Clark level (IV + V), abnormal serum lactate dehydrogenase (LDH), distant metastases occurrence and Ki-67 >= 30 (P < 0.05). The area under the curves (AUCs) of HSP90 alpha was greater than LDH in the training (0.847 vs. 0.677) and validation (0.867 vs. 0.672) cohort. Meanwhile, the sensitivity (76.70) and negative predictive values (78.80) of HSP90 alpha were higher. Plasma HSP90 alpha levels were significantly reduced in objective response (81.05 vs. 37.26 ng/mL; P = 0.012) and disease control patients (84.16 vs. 47.05 ng/mL; P = 0.002) post-treatment. Patients with normal HSP90 alpha levels had slightly longer progression-free survival (PFS) than those with abnormal levels (8.0 vs. 3.5 months; P = 0.096). Unfortunately, the trend was not statistically significant. In multivariable analysis, immunotherapy was an independent prognostic factor for PFS. Nevertheless, patients with normal HSP90 alpha levels who received chemotherapy(+/- targeted therapy) without immunotherapy had significantly longer PFS than patients with abnormal levels (6.0 vs. 2.0 months; P = 0.008). Therefore, HSP90 alpha can be used for auxiliary diagnosis and predict the responses to therapy in malignant melanoma patients.