Diagnostic Value Of Hsp90?,VEGF And CEA In Benign And Malignant Pleural Effusions

Objective: The aim of the study was to evaluate the clinical validity of heat shock protein 90?(Hsp90?),vascular endothelial growth factor(VEGF)and carcinoembryonic antigen(CEA)in discriminating between malignant and benign pleural effusion.Methods: Eighty patients with pleural effusion admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from September 2016 to September 2018 were enrolled,including 40 patients with malignant pleural effusion and 40 patients with benign pleural effusion.The levels of Hsp90?,VEGF and CEA in pleural effusion were detected by double antibody sandwich ELISA.Mann-Whitney U Rank Sum Test were used to compare the measurement data,and the counting data were tested by ?2 test.The ROC curve was drawn with sensitivity as longitudinal coordinate and 1-specificity as transverse coordinate,and the area under the curve was calculated.The best diagnostic boundary point,diagnostic sensitivity and specificity were selected,and the diagnostic efficacy of the three indexes was calculated.All the tests were statistically significant(P < 0.05).Results: 1.The expression levels of Hsp90?,VEGF and CEA in malignant pleural effusion were significantly higher than those in benign pleural effusion(P<0.001).2.The ROC curve showed that the area under the curve of Hsp90? was 0.852(95%CI,0.764-0.941).When the optimum critical value was 1413.43pg/ml,the sensitivity and specificity of Hsp90? were 88% and 82%,respectively.The ROC curve showed that the area under the curve of VEGF was 0.798(95%CI,0.696-0.900).The ROC curve showed that the area under the curve of VEGF was 0.798(95%CI,0.696-0.900).When the optimum critical value was 484.13pg/ml,the sensitivity and specificity of VEGF were 75% and 82%,respectively.The sensitivity and specificity of CEA were 75% and 97% respectively at the best critical value of 6.03ng/ml.The ROC curve showed that the area under the curve of CEA was 0.907(95%CI,0.843-0.971).3.The sensitivity and specificity of combined detection of Hsp90? and VEGF were 95.0% and 67.5%,respectively.The area under the curve was 0.886(95% CI,0.811-0.962).The sensitivity and specificity of combined detection of Hsp90? and CEA were 95.0% and 80.0%,respectively.The area under the curve was 0.949(95% CI,0.905-0.994).The sensitivity and specificity of combined detection of VEGF and CEA were 90.0% and 80.0%,respectively.The area under the curve was 0.929(95% CI,0.864-0.995).The sensitivity and specificity of the three indexes were 97.5% and 67.5%,and the area under the ROC curve was 0.963(95% CI,0.927-0.998).Conclusion: 1.The expression of Hsp90?,VEGF and CEA in malignant pleural effusion is significantly higher than that in benign pleural effusion,which can be used as a valuable biomarker to distinguish malignant pleural effusion from benign pleural effusion.2.The sensitivity of combined detection of Hsp90?,VEGF and CEA was higher than that of single detection.The sensitivity of combined detection of the three indexes was the highest(97.5%),but the combined specificity was the lowest(67.5%).3.Combining the ROC curve of individual and Joint detection of each index,the highest area under the curve was three joint detection(0.963),and the lowest was VEGF single detection(0.798).It is suggested that the combined detection contributes to higher diagnostic efficiency.4.According to the sensitivity and specificity of single and combined detection of each index,the combined detection of Hsp90? and CEA is recommended,because it has relatively high sensitivity and specificity at the same time.