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Elevated plasma HSP90α as a prognostic marker in EGFR‑mutant non‑small cell lung cancer

  • Authors:
    • Xiaoyu Tan
    • Jiaying Tang
    • Yamei Tang
    • Haiguang Wang
    • Shanli Mo
    • Xiaoqian Huang
    • Haijie Gan
  • View Affiliations / Copyright

    Affiliations: Department of Experimental Research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China, Department of Respiratory Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
    Copyright: © Tan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 457
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    Published online on: July 22, 2025
       https://doi.org/10.3892/ol.2025.15203
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Abstract

The heat shock protein 90α (HSP90α), as a molecular chaperone, plays an important role in the development and progression of various malignant tumors. The aim of the present study was to assess the plasma level of heat shock protein 90α (HSP90α) in patients with non‑small cell lung cancer (NSCLC) harboring different epidermal growth factor receptor (EGFR) mutations and its association with clinical characteristics and EGFR gene mutations. Plasma HSP90α levels, clinicopathological data and prognostic information were collected and analyzed from 1,347 patients with a pathological diagnosis of lung cancer to evaluate their association with EGFR gene mutations. The results demonstrated that patients with elevated plasma HSP90α levels are more likely to have SCLC, advanced tumor stages and poorer prognosis compared to patients with lower HSP90α levels. Among patients with NSCLC harboring EGFR mutations, those with higher plasma HSP90α levels are more frequently associated with L858R wild‑type and exon 20 mutations compared to other EGFR mutation subtypes. Furthermore, using the optimal cutoff value of 62.1 ng/ml for plasma HSP90α levels, the results revealed that patients with lower plasma HSP90α levels have a better prognosis compared to those with higher HSP90α levels. In conclusion, elevated plasma HSP90α expression is associated with poor overall survival in patients with NSCLC and could serve as a prognostic indicator independent of EGFR mutation status.
View Figures

Figure 1

Box plots of plasma HSP90α expression
according to different clinical characteristics. (A) Pathological
classification revealing that plasma HSP90α levels were
significantly higher in SCLC compared with LUSC, LUAD and other
histological types. (B) Plasma HSP90α expression was significantly
higher in patients with stage IV lung cancer than in those with
earlier stages. Higher plasma HSP90α levels were demonstrated in
patients with advanced (C) T, (D) N and (E) M stages. (F) Patients
with lung cancer who died had significantly higher plasma HSP90α
expression than survivors. Group differences were assessed using
the Mann-Whitney U-test for two groups or the Kruskal-Wallis test
for comparisons involving >2 groups. HSP90α, heat shock protein
90α; SCLC, small cell lung cancer; LUSC, lung squamous cell cancer;
LUAD, lung adenocarcinoma; T, tumor; N, node; M, metastasis.

Figure 2

Box plots of plasma HSP90α expression
according to different EGFR mutation types. (A) EGFR mutation
status did not significantly affect plasma HSP90α levels. (B)
Plasma HSP90α expression in patients with exon 19 deletion was
comparable with that in wild type patients. (C) Plasma HSP90α
levels were significantly decreased in patients with the exon 21
L858R mutation. (D) Patients with exon 20 mutations demonstrated
significantly higher plasma HSP90α expression. (E) Plasma HSP90α
expression was not significantly elevated in patients with T790M
mutations. (F) There was no significant difference in plasma HSP90α
levels between patients with multiple EGFR mutations and those with
wild-type EGFR. Group differences were assessed using the
Mann-Whitney U-test (two independent groups) or Kruskal-Wallis test
for comparisons involving >2 groups. HSP90α, heat shock protein
90α; EGFR, epidermal growth factor receptor; WT, wild type; MT,
mutant.

Figure 3

Selection of the optimal cutoff value
for plasma HSP90α expression. (A) Density distribution of plasma
HSP90α levels. Using the Log-rank test, the optimal cutoff value
was determined to be 62.1 ng/ml. (B) Based on the cutoff, patients
with lung cancer were stratified into risk groups, and overall
survival curves were plotted. The high-risk group demonstrated a
significantly worse prognosis (Log-rank P<0.01). HSP90α, heat
shock protein 90α.
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Copy and paste a formatted citation
Spandidos Publications style
Tan X, Tang J, Tang Y, Wang H, Mo S, Huang X and Gan H: Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer. Oncol Lett 30: 457, 2025.
APA
Tan, X., Tang, J., Tang, Y., Wang, H., Mo, S., Huang, X., & Gan, H. (2025). Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer. Oncology Letters, 30, 457. https://doi.org/10.3892/ol.2025.15203
MLA
Tan, X., Tang, J., Tang, Y., Wang, H., Mo, S., Huang, X., Gan, H."Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer". Oncology Letters 30.4 (2025): 457.
Chicago
Tan, X., Tang, J., Tang, Y., Wang, H., Mo, S., Huang, X., Gan, H."Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer". Oncology Letters 30, no. 4 (2025): 457. https://doi.org/10.3892/ol.2025.15203
Copy and paste a formatted citation
x
Spandidos Publications style
Tan X, Tang J, Tang Y, Wang H, Mo S, Huang X and Gan H: Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer. Oncol Lett 30: 457, 2025.
APA
Tan, X., Tang, J., Tang, Y., Wang, H., Mo, S., Huang, X., & Gan, H. (2025). Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer. Oncology Letters, 30, 457. https://doi.org/10.3892/ol.2025.15203
MLA
Tan, X., Tang, J., Tang, Y., Wang, H., Mo, S., Huang, X., Gan, H."Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer". Oncology Letters 30.4 (2025): 457.
Chicago
Tan, X., Tang, J., Tang, Y., Wang, H., Mo, S., Huang, X., Gan, H."Elevated plasma HSP90&alpha; as a prognostic marker in EGFR‑mutant non‑small cell lung cancer". Oncology Letters 30, no. 4 (2025): 457. https://doi.org/10.3892/ol.2025.15203
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