血清高迁移率组蛋白B1、可溶性晚期糖基化终末产物受体、脱氧核糖核酸酶与TACE早期疗效相关性研究

Correlation study between HMGB1,sRAGE,DNase and the short-term efficacy of TACE

目的探讨原发性肝癌患者血清高迁移率组蛋白B1(HMGB1)、人可溶性晚期糖基化终末产物(sRAGE)、脱氧核糖核酸酶(DNase)对TACE近期疗效的评估价值。方法对收住的42例患者(共计56次TACE治疗)分别在TACE术前、术后24 h采集外周静脉血标本,用ELISA法检测外周血清中HMGB1、sRAGE、DNase的表达水平。根据mRECIST标准进行TACE术后疗效评估,将完全缓解+部分缓解+疾病稳定的病例归为获益组,疾病进展者归为无效组。比较TACE术前、术后,获益组及无效组之间的血清HMGB1、sRAGE、Dnase的表达水平,并进行统计学分析。结果 TACE术前与术后24 h血清HMGB1、sRAGE、DNase表达水平比较差异有显著统计学意义(P=0.003,P=000,P=0.001),且术后较术前呈升高趋势。56例次TACE中,24例次为稳定(SD),2例次部分缓解(PR),30例次为肿瘤进展(PD),将SD和PR患者归为获益组(n=26),PD患者为无效组(n=30)。在TACE术前,获益组与无效组血清HMGB1、DNase表达水平比较差异无统计意义(P=0.395,P=0.091);在TACE术后24 h,血清HMGB1、DNase在获益组和无效组对比差异也无统计学意义(P=0.354,P=0.182)。而sRAGE在获益组与无效组之间的表达水平在术前差异无统计学意义(P=0.143),而在术后24 h,两组间sRAGE表达水平差异有统计学意义(P=0.030)。结论 1TACE术后血清HMGB1、sRAGE、DNase表达水平较术前升高;2中晚期肝癌患者外周血清中sRAGE与TACE疗效相关,可以作为TACE治疗肝癌疗效早期评估的指标。

[ Abstract] Objective To discuss the value of high-mobility group protein B1 （HMGB1）, soluble receptor of advanced glycation end product （sRAGE） and deoxyribonuclease （DNase） in predicting the short- term efficacy of transcatheter arterial ehemoembolization （ TACE ）. Methods Serum samples were collected from 42 patients with hepatocellular carcinoma （ HCC ） before and 24 hours after TACE. A total of 56 times of TACE procedure were performed in the 42 patients. The expression levels of HMGB1, sRAGE and DNase in the peripheral serum samples were determined with ELISA method. According to RECIST criteria, the curative effects of TACE were evaluated. The patients of complete remission （CR）, partial remission （PR）, and stable disease （SD） were classified as the benefit group, and the patients with progress disease （PD） were classified as the invalid group. The pre-TACE and post-TACE expression levels of HMGBI, sRAGE and DNase were compared between the two groups, and the results were statistically analyzed. Results The post-TACE expression levels of HMGB1, sRAGE and DNasewere significantly different from pre-TACE ones, the differences were statistically significant （ P = 0.003, P = 0.000 and P = 0.001 respectively） , moreover, the post- TACE expression levels of HMGB1, sRAGE and DNase showed an upward increasing trend. Of the 56 times of TACE procedure, SD was obtained in 24, PR in 2 and PD in 30. The patients of SD and PR were classified as the benefit group （n = 26）, and the patients of PD were classified as the invalid group （n--30）. Before TACE, no statistically significant differences in the expression levels of HMGB1 and DNase existed between the benefit group and the invalid group （P = 0.395, P = 0.091 ） , and 24 hours after TACE the differences in the expression levels of HMGB1 and DNase between the benefit group and the invalid group were also not statistically significant （P = 0.354, P = 0.182）. The difference in pre-TACE expression level of sRAGE between the benefit group and the invalid group was not statistically significant （P= 0.143） , but 24 hours after TACE the difference in the level of sRAGE between the benefit group and the invalid group became statistically significant （P = 0.030）. Conclusion （1） The post-TACE expression levels of HMGB1, sRAGE and DNase are higher than the pre-TACE ones. （2）In advanced HCC patients, the expression level of sRAGE in peripheral serum bears a close relationship to the curative effect of TACE, therefore, it can be used as an index to evaluate the short- term efficacy of TACE for HCC.