分析热休克蛋白90α(heat shok protein 90 α，HSP90α)、肿瘤相关肽(tumor-associated peptides, TAP)、白细胞介素6(interleukin-6, IL-6)在非小细胞肺癌(non-small cell lung cancer, NSCLC)恶性胸腔积液诊断及预后中的意义。

选取2020年1月至2024年12月我院收治的胸腔积液患者65例，根据胸腔积液类型分组，良性胸腔积液31例为对照组，恶性胸腔积液为观察组34例。采用酶联免疫吸附法检测血清癌胚抗原(carcinoembryonic antigen, CEA)、细胞角蛋白可溶性片段211(cytokeratin 19 fragment, CYFRA 21-1)、神经元特异性烯醇化酶(neuron-specific enolase, NSE)及HSP90α、TAP、IL-6水平。采用受试者工作曲线(receiver operating curve, ROC)判断肿瘤标志物与HSP90α、TAP、IL-6对NSCLC恶性胸腔积液患者的诊断意义，绘制NSCLC恶性胸腔积液患者生存曲线。

对照组血清CEA(4.12±1.14)ng/ml、CYFRA 21-1(12.82±3.75)ng/ml、NSE(3.05±1.33) ng/ml水平低于观察组CEA(6.64±1.88) ng/ml、CYFRA 21-1(15.85±4.15) ng/ml、NSE (5.91±2.05 )ng/ml(P<0.05)；胸水HSP90α(16.20±7.90)ng/ml、TAP(133.00±17.86)μm²、细胞核DNA合成酶(thymidine kinase 1, TK1)(4.80±2.08)pmol/L、鳞状细胞癌抗原(squamous cell carcinoma antigen, SCC)(5.58±1.98)mg/L、乳酸脱氢酶(lactate dehydrogenase, LDH)(137.33±27.84)U/L、IL-6(6.52±1.30)pg/L水平低于观察组HSP90α(176.10±86.54) ng/ml、TAP (173.16±19.51)μm²、TK1(9.26±2.93) pmol/L、SCC(7.13±2.23) mg/L、LDH (195.74±26.78) U/L、IL-6(8.51±1.31) pg/L(P<0.05)。ROC曲线分析显示，诊断恶性胸腔积液HSP90α高于TAP、IL-6、TK1、SCC、LDH和CEA＋CYFRA21-1＋NSE联合诊断，灵敏性为97.1%，特异性为96.8%，曲线下面积(area under the curve, AUC)为0.963，95%CI：0.906~1.000。K-M曲线显示，HSP90α、TAP、IL-6水平越高，恶性胸腔积液患者生存期越短。Log-Rank分析显示，HSP90α、TAP、IL-6的卡方与统计学值分别为66.639、35.201、25.048；0.000、0.000、0.000。

HSP90α、TAP和IL-6可作为预测NSCLC恶性胸腔积液患者预后的指标，具有临床意义。

To analyze the value of heat shock protein 90α (HSP90α), tumor-associated peptides (TAP), and interleukin-6 (IL-6) in the diagnosis and prognosis of malignant pleural effusion in non-small cell lung cancer (NSCLC).

A total of 65 patients with pleural effusion admitted to our hospital from January 2020 to December 2024 were selected. Based on the type of pleural effusion, they were divided into two groups: 31 cases with benign pleural effusion as the control group and 34 cases with malignant pleural effusion as the observation group. Serum levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA 21-1), neuron-specific enolase (NSE), HSP90α, TAP, and IL-6 were measured using enzyme-linked immunosorbent assay. The diagnostic value of tumor markers, HSP90α, TAP, and IL-6 for NSCLC malignant pleural effusion was assessed using receiver operating characteristic (ROC) curves, and survival curves were plotted for patients with NSCLC malignant pleural effusion.

The serum levels of CEA (4.12±1.14) ng/ml, CYFRA 21-1 (12.82±3.75) ng/ml, and NSE (3.05±1.33) ng/ml in the control group were lower than those in the observation group CEA (6.64±1.88) ng/ml, CYFRA 21-1 (15.85±4.15) ng/ml, NSE (5.91±2.05) ng/ml (P<0.05). The levels of serum HSP90α(16.20±7.90) ng/ml, TAP (133.00±17.86) μm², thymidine kinase 1 (TK1) (4.80±2.08) pmol/L, squamous cell carcinoma antigen (SCC) (5.58±1.98) mg/L, lactate dehydrogenase (LDH) (137.33±27.84) U/L, and IL-6 (6.52±1.30) pg/L in the control group were lower than those in the observation group HSP90α(176.10±86.54) ng/ml, TAP (173.16±19.51) μm², TK1 (9.26±2.93) pmol/L, SCC (7.13±2.23) mg/L, LDH (195.74±26.78) U/L, IL-6 (8.51±1.31) pg/L (P<0.05). ROC curve analysis showed that HSP90α had higher diagnostic value for malignant pleural effusion compared to TAP, IL-6, TK1, SCC, LDH, and the combined diagnosis of CEA + CYFRA 21-1 + NSE, with a sensitivity of 97.1%, specificity of 96.8%, and an area under the curve (AUC) of 0.963 (95%CI: 0.906~1.000). K-M curves showed that higher levels of HSP90α, TAP, and IL-6 were associated with shorter survival in patients with malignant pleural effusion. Log-Rank analysis revealed chi-square and statistical values for HSP90α, TAP, and IL-6 as 66.639, 35.201, and 25.048, respectively, with P-values of 0.000, 0.000, and 0.000.

HSP90α, TAP, and IL-6 can serve as indicators for predicting the prognosis of NSCLC patients with malignant pleural effusion and hold clinical significance.