血清高迁移率族蛋白B1检测在T3NOM0期前列腺癌冷冻治疗后复发中的意义

摘要

目的 探讨血清高迁移率族蛋白B1 (HMGBl)预测T3N0M0期前列腺癌冷冻治疗后复发的临床意义.方法 收集65例T3期前列腺癌患者(PCa组)和30例前列腺良性增生患者(BPH组)的血清样本,应用酶联免疫吸附试验测定血清HMGBl水平；PCa组患者均行经皮穿刺冷冻消融治疗,术后随访外周血前列腺特异抗原(PSA)、前列腺MRI,可疑复发者行病理穿刺活检证实.比较PCa组患者血清HMGB1水平.结果 术前血清HMGB1在PCa组为(55.28±29.37)ng/ml,明显高于BPH组的(34.61±13.15)ng/ml(P=0.004).PCa组患者冷冻治疗后,无复发46例,局部复发15例,远处转移4例,三者术前HMGB1平均值分别为(55.49±7.12)ng/ml、(73.13±7.89)ng/ml和(94.23±17.91)ng/ml,差异有统计学意义(P＜0.01).结论 术前血清HMGB1水平高的PCa患者冷冻治疗后复发、转移率较高,血清HMGB1的检测可为冷冻治疗后复发性前列腺癌的诊断提供重要临床价值.%Objective To investigate the clinical application of serum high - mobility group box 1 protein (HMGB1) in forecasting the early recurrence of stage T3N0M0 prostate cancer after cryotherapy. Methods A total of 65 patients with stage T3N0M0 prostate cancer (PCa group) and 30 patients with benign prostate hyperplasia (BPH group) were collected. Enzyme - linked immunosorbent assay (ELISA) was used to determine the serum HMGB1 and PSA levels in all patients. Percutaneous cryoablation therapy was performed in the patients of PCa group. Follow-up examinations with determination of PSA level in peripheral blood and MRI scanning of the prostate were carried out, and puncturing biopsy was employed in patients who was suspected of having recurrent cancer. The results were analyzed, and the HMGB1 levels of the two groups were compared. Results Before the treatment, the HMGB1 levels of the PCa group and the BPH group were (55.28 ± 29.37) ng/ml and (34.61 ± 13.15) ng/ml respectively. The HMGB1 level of the PCa group was significantly higher than that of the BPH group (P = 0.004). Of the 65 patients with stage T3N0M0 prostate cancer after percutaneous cryoablation therapy, no recurrence was seen in 46, local recurrence in 15 and distant metastasis in 4, and the preoperative HMGB1 levels of these three groups were (55.49 ±7.12) ng/ ml, (73.13 ± 7.89) ng/ml and (94.23 ± 17.91) ng/ml respectively. The differences in the preoperative HMGB1 level among the three groups were statistically significant (P < 0.01). Conclusion This study indicates that patients with stage T3N0M0 prostate cancer have higher recurrence rate and metastasis rate after percutaneous cryoablation therapy if their preoperative HMGB1 levels are higher. Therefore, serum HMGB1 level can be used as a helpful prognostic factor for predicting the recurrence of prostate cancer after percutaneous cryoablation therapy.