肝细胞癌患者行TACE前后HMGB1表达变化及其对预后的影响

Change of HMGB1 expression before and after TACE in patients with hepatocellular carcinoma and its effect on prognosis

目的观察肝细胞癌患者经导管动脉化疗栓塞术（TACE）前后血清中高迁移率族蛋白B1（HMGB1）的表达变化及其对预后的影响。方法以2012年6月至2014年6月在山东省肿瘤医院仅接受TACE治疗的68例肝细胞癌患者为研究对象，所有患者均于行TACE术前1天、术后1个月检测血清中HMGB1水平，比较TACE治疗前后HMGB1表达变化。根据参考资料将患者分为高表达组（HMGB1≥17.5 ng/ml）和低表达组（HMGB1＜17.5 ng/ml），比较两组患者近期疗效及生存情况。结果患者TACE术前HMGB1水平为（40.6±13.6）ng/ml，术后1个月HMGB1水平为（20.1±6.9）ng/ml，两者相比差异有统计学意义（t=4.22，P=0.040）。TACE术后HMGB1低表达组患者肿瘤治疗有效率为65.00%，HMGB1高表达组治疗有效率为39.29%，差异有统计学意义（χ2=4.390，P=0.036）。HMGB1低表达组患者1、2、3年生存率分别为77.50%、50.00%和27.50%，均显著高于HMGB1高表达组患者（57.14%、21.43%和7.14%），两组生存率差异有统计学意义（χ2=8.301，P=0.040）。结论 TACE可降低肝细胞癌患者血清中HMGB1表达水平，低表达的HMGB1提示患者近期疗效良好，生存时间较长。

ObjectiveTo observe the change of high mobility group protein B1 （HMGB1） in patients with hepatocellular carcinoma （HCC） before and after transcatheter arterial chemoembolization （TACE） and its effect on prognosis. MethodsA total of 68 HCC patients only with TACE treatment were selected as the research objects from June 2012 to June 2014 in Shandong Tumor Hospital. The serum levels of HMGB1 of all the patients were detected 1 day before TACE and 1 month after TACE. The change of HMGB1 expression before and after TACE was analyzed. According to the reference data, the patients were divided into the highexpression group （≥17.5 ng/ml） and the lowexpression group （〈17.5 ng/ml）. The shortterm efficacy of the two groups of patients and their survival time were compared. ResultsThe preoperative HMGB1 level of patients was （40.6±13.6）ng/ml, and the 1month postoperative HMGB1 level was （20.1±6.9）ng/ml, and the difference was statistically significant （t=4.22, P=0.040）. The effective rate in patients with low HMGB1 expression after TACE was 65.00%, and 39.29% in patients with high HMGB1 expression, with a significant difference （χ2=4.390, P=0.036）. The 1, 2, and 3 year survival rates of low HMGB1 expression group were 77.50%, 50.00% and 27.50%, respectively, which were significantly higher than high HMGB1 expression group （57.14%, 21.43% and 7.14%）, with a significant difference （χ2=8.301, P=0.040）. ConclusionTACE can reduce the HMGB1 expression level in serum of patiens with HCC. The patients with low expression of HMGB1 have the better shortterm efficacy and the longer survival time.