HMGB1在III期直肠癌患者肿瘤组织中的表达及与预后的关系

The Expression of HMGB1 in Tumor Tissues of Patients with Stage III Rectal Cancer and Its Relationship with Prognosis

目的探讨高迁移率组蛋白B1(HMGB1)与III期直肠癌患者临床病理特征及术后3年无疾病生存(DFS)的关系。方法选取我院2011年2月至2015年12月诊治的III期直肠癌术后患者组织标本46例,免疫组化方法检测组织中HMGB1蛋白的表达情况,随访患者术后3年DFS。结果HMGB1在直肠癌组织中高表达24例,占52.2%,在癌旁组织中高表达10例,占21.7%,差异有统计学意义(χ2=9.144,P=0.002)。HMGB1的表达与III期直肠癌患者年龄、性别、手术方式、是否存在脉管癌栓或神经侵犯、pT分期、术前CEA水平、肿瘤生长类型无关,与pN分期、肿瘤分化程度、是否合并癌结节有关。46例III期直肠癌患者术后3年复发22例,总DFS率为52.2%,单因素分析显示HMGB1、分化程度、脉管癌栓或神经侵犯、术前CEA水平、pN分期与预后有关。多因素分析显示分化程度和术前CEA水平为独立预后因素。结论HMGB1的表达与III期直肠癌pN分期、肿瘤分化程度、是否合并癌结节有关。HMGB1高表达可能是III期直肠癌患者术后3年DFS的不利影响因素,但尚不能作为独立预后因素,检测HMGB1的表达对预后判断有一定的价值。

Objective To investigate the relationship between the high mobility group histone B1(HMGB1)and the clinical pathological features of patients with stage III rectal cancer and 3 years disease-free survival(DFS).Methods Forty-six patients with stage III rectal cancer after operation from February,2011 to December,2015 were enrolled for the study.Immunohistochemistry was used to detect the expression of HMGB1 protein.We then investigated the relationship between HMGB1 protein expression and clinicopathological features of patients with stage III rectal cancer,and analyzed the relationship between HMGB1 protein expression and 3 years DFS.Results HMGB1 was highly expressed in rectal cancer tissues in 24 cases,accounting for 52.2%,while in 10 cases,HMGB1 was highly expressed in adjacent tissues,accounting for 21.7%,with the significant difference(χ2=9.144,P=0.002).The expression of HMGB1 was not associated with age,gender,surgical procedure,presence of vascular tumor thrombus or neurological invasion,pT stage,preoperative CEA level,tumor growth type,but was associated with pN stage,tumor differentiation,and cancer nodules.Among the 46 patients,22 patients relapsed 3 years after the surgery.The total DFS rate was 52.2%.Univariate analysis showed that HMGB1,degree of differentiation,vascular tumor thrombus or neurological invasion,preoperative CEA levels,and pN stage were associated with prognosis.Multivariate analysis showed that the degree of differentiation and preoperative CEA levels were independent prognostic factors.Conclusion The expression of HMGB1 is related to the stage of pN stage,the degree of tumor differentiation,and the presence of cancer nodules in stage III rectal cancer.High expression of HMGB1 may be an adverse factor affecting 3 years DFS in patients with stage III rectal cancer after the operation,but it is not significant enough as an independent prognostic factor.Testing HMGB1 can be informative for the prognosis.