胃癌患者外周血高迁移率族蛋白B-1水平的检测及临床意义

摘要

目的 探讨高迁移率族蛋白B-1(HMGB1)在胃癌患者血清中的变化及临床意义.方法 采用双抗体夹心酶联免疫吸附试验(ELISA)检测101例胃癌患者血清中HMGB1水平,同时用电化学发光法(ECL)测定血清癌胚抗原(CEA)含量,并与31例胃良性病变患者、40名正常对照者比较,数据用中位数(范围)表示.结果 胃癌组患者血清HMGB1和CEA水平分别为15.58 (3.05 ～ 125.63) ng,/mL、11.75 (0.85～850.23) ng/mL,胃良性病变组患者血清HMGB1和CEA水平分别为4.46(2.61～ 12.06) ng/mL、2.75 (0.52～ 11.23) ng/mL,正常对照组血清HMGB1和CEA水平分别为3.24 (2.50～ 5.38) ng/mL、1.23 (0.45～4.56) ng/mL,胃癌组患者血清HMGB1和CEA水平显著高于胃良性病变组和正常对照组(P＜0.01).血清HMGB1水平与胃癌患者肿瘤大小、浸润深度、TNM分期、淋巴结转移密切相关(P均＜0.05).与传统的肿瘤标志物CEA相比,血清HMGB1在早期胃癌患者中显示良好的诊断敏感性(72.2％)和特异性(74.6％).结论 HMGB1与胃癌的发生、发展有关,检测血清HMGB1含量对于提高胃癌的早期诊断水平、监测病情变化、判断预后具有重要的临床价值.%Objective To investigate the change and clinical significance of serum high mobility group protein box-1 ( HMGB1) in patients with gastric cancer. Methods The serum levels of HMGB1 were determined by enzyme-linked immunosorbent assay (ELISA) in 101 patients with gastric cancer, 31 patients with benign gastric diseases and 40 healthy controls. Simultaneously, serum carcinoembryonic antigen (CEA) was determined by electrochemiluminescence (ECL). The results were expressed as median (range). Results The levels of serum HMGB1 and CEA in patients with gastric cancer were 15.58(3. 05-125. 63) ng/mL and 11. 75(0. 85-850. 23) ng/mL. The levels of serum HMGB1 and CEA in patients with benign gastric diseases were 4.46(2. 61-12. 06) ng/mL and 2. 75(0. 52-11. 23) ng/mL. The levels of serum HMGB1 and CEA in healthy controls were 3. 24(2.50-5. 38) ng/mL and 1.23(0.45- 4.56) ng/mL. The levels of serum HMGB1 and CEA in patients with gastric cancer were significantly higher than those in patients with benign gastric diseases and healthy controls ( P <0. 01) . The levels of serum HMGB1 were significantly associated with tumor size,gastric wall invasion, TNM stage and lymph node metastasis( P < 0. 05 ). Compared to the traditional tumor marker CEA, the diagnostic sensitivity and specificity of serum HMGB1 were 72. 2% and 74. 6% for the diagnosis of early gastric cancer. Conclusions HMGB1 plays a role in the tumorigenesis and development of gastric cancer. The determination of HMGB1 in serum of patients with gastric cancer is helpful for improving early diagnosis, monitoring and predicting the prognosis in gastric cancer.