目的:探讨肝细胞肝癌组织中高迁移率族蛋白1(high mobility group box 1,HMGB1)蛋白表达情况及其对肿瘤预后的影响.方法:收集本院2004年1月至2004年12月期间首次诊断,并行肝癌根治性切除术、术后病理确诊为肝细胞癌、随访资料完整的肝癌患者98例,并收集2009年1月～2010年12月在本院行肝血管瘤切除的肝组织30例作为正常肝脏组织对照,免疫组化法检测肝癌及癌旁组织、正常肝组织中HMGB1蛋白表达情况;并分析HMGB1的表达水平与各临床病理参数的相关性,及其对总体生存率和无瘤生存率的影响.结果:HMGB1主要表达在细胞质中,肿瘤组织表达率为91.84%,癌旁组织表达率为21.43%,正常肝组织无表达.相关性分析显示HMGB1的表达高低与肿瘤包膜的情况存在相关,与其他各临床病理参数均无相关性.全组1、3、5年总体生存率为:83.5%、58.2%、49.4%;无瘤生存率为:60.7%、40.6%、36.8%.Cox多因素分析显示HMGB1表达水平是影响总体生存率、无瘤生存率的独立预后因素;HMGB1高表达组(57例),无或低表达组(41例)1、3、5年生存率分别为75.4%、42.7%、37.7%及89.3%、69.3%、57.5%(P=0.028);相应的无瘤生存率分别为50.1%、31.6%、26.1%及68.4%、47.1%、45.1%(P=0.047).结论:HMGB1 在肝细胞肝癌组织中呈高表达,其表达水平与肿瘤包膜的完整性呈负相关,HMGB1的高表达是肝癌根治性切除术后的总体生存率和无瘤生存率的独立预后因素,可以作为肝癌根治性切除术后的预后预测因子之一.%Objectives: To investigate the expression of high-mobility group box 1 ( HMGB1 ) in hepatocellular carcinoma ( HCC ) and to analyze the association of HMGB1 expression with clinicopathologic characteristics and prognosis. Methods: Ninety-eight patients diagnosed with HCC after pathological analysis received curative hepatectomy from January 2004 to December 2004. Their complete follow-up data were collected, and they were used as study population. Thirty cases with hepatic hemangioma resection were selected as contrast. Immunohistochemistry method was used to detect the expression of HMGB1. The association of HMGB1 expression with clinicopathologic characteristics and overall and recurrence-free survivals was analyzed. Results: Expression of HMGB1 was observed mainly in the cytoplasm. HMGB1 was recorded in 90 ( 91.84 % ) of 98 tumor tissues, 21.43 % in juxtacancerous tissues, and none in normal hepatic tissues. There was no correlation between the expression of HMGB1 and clinicopathologic characteristics, except for the tumor capsule. The 1-, 3-, and 5-year overall survivals of 98 patients were 83.5 %, 58.2 %, and 49.4 %, respectively, and the corresponding recurrence-free survivals were 60.7 %, 40.6 %, and 36.8 %, respectively. Multivariate analysis showed that HMGB1 was an independent prognostic factor for overall and recurrence-free survivals. The 1-, 3-, and 5-year overall survival rates for the patients with HMGB1 high expression ( n = 57 ) and with no or low expression ( n = 41 ) were 75.4 %, 42.7 %, and 37.7 % and 89.3 %, 69.3 %, and 57.5 %, respectively ( P = 0.028 ). The corresponding recurrence-free survivals were 50.1 %, 31.6 %, and 26.1 % and 68.4 %, 47.1 %, and 45. 1%, respectively ( P = 0.047 ). Conclusion: The overexpression of HMGB1 is a prognostic predictor for patients with HCC after curative hepatectomy.
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