A novel pan-cancer biomarker plasma heat shock protein 90alpha and its diagnosis determinants in clinic

Cancer Sci. 2019 Sep;110(9):2941-2959. doi: 10.1111/cas.14143. Epub 2019 Aug 9.

Abstract

A sensitive and specific diagnosis biomarker, in principle scalable to most cancer types, is needed to reduce the prevalent cancer mortality. Meanwhile, the investigation of diagnosis determinants of a biomarker will facilitate the interpretation of its screening results in clinic. Here we design a large-scale (1558 enrollments), multicenter (multiple hospitals), and cross-validation (two datasets) clinic study to validate plasma Hsp90α quantified by ELISA as a pan-cancer biomarker. ROC curve shows the optimum diagnostic cutoff is 69.19 ng/mL in discriminating various cancer patients from all controls (AUC 0.895, sensitivity 81.33% and specificity 81.65% in test cohort; AUC 0.893, sensitivity 81.72% and specificity 81.03% in validation cohort). Similar results are noted in detecting early-stage cancer patients. Plasma Hsp90α maintains also broad-spectrum for cancer subtypes, especially with 91.78% sensitivity and 91.96% specificity in patients with AFP-limited liver cancer. In addition, we demonstrate levels of plasma Hsp90α are determined by ADAM10 expression, which will affect Hsp90α content in exosomes. Furthermore, Western blotting and PRM-based quantitative proteomics identify that partial false ELISA-negative patients secret high levels of plasma Hsp90α. Mechanism analysis reveal that TGFβ-PKCγ gene signature defines a distinct pool of hyperphosphorylated Hsp90α at Theronine residue. In clinic, a mechanistically relevant population of false ELISA-negative patients express also higher levels of PKCγ. In sum, plasma Hsp90α is a novel pan-cancer diagnosis biomarker, and cancer diagnosis with plasma Hsp90α is particularly effective in those patients with high expression of ADAM10, but may be insufficient to detect the patients with low ADAM10 and those with hyperphosphorylated Hsp90α.

Keywords: ADAM10; Hsp90α; PKCγ; heterogeneity; pan-cancer biomarker.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • ADAM10 Protein / genetics
  • ADAM10 Protein / metabolism
  • Adolescent
  • Adult
  • Amyloid Precursor Protein Secretases / genetics
  • Amyloid Precursor Protein Secretases / metabolism
  • Animals
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / metabolism
  • Cell Line, Tumor
  • Child
  • Child, Preschool
  • Datasets as Topic
  • Enzyme-Linked Immunosorbent Assay
  • Exosomes / metabolism
  • False Negative Reactions
  • Female
  • HSP90 Heat-Shock Proteins / blood*
  • HSP90 Heat-Shock Proteins / metabolism
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Membrane Proteins / genetics
  • Membrane Proteins / metabolism
  • Mice
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / diagnosis*
  • Neoplasms / pathology
  • Phosphorylation
  • Prospective Studies
  • ROC Curve
  • Threonine / metabolism
  • Xenograft Model Antitumor Assays
  • Young Adult

Substances

  • Biomarkers, Tumor
  • HSP90 Heat-Shock Proteins
  • HSP90AA1 protein, human
  • Membrane Proteins
  • Threonine
  • Amyloid Precursor Protein Secretases
  • ADAM10 Protein
  • ADAM10 protein, human