Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan.
World J Surg Oncol. 2019 Aug 9;17(1):140. doi: 10.1186/s12957-019-1675-8.
Expression of High-Mobility Group Box 1 (HMGB1), a multifunctional protein involved in DNA function as well as cell proliferation, inflammation, and the immune response, has been reported to be prognostic in several types of malignancies. However, the prognostic value of HMGB1 in ampullary cancer has not been studied.
Patients with adenocarcinoma of the ampulla of Vater who underwent R0 resection with pancreaticoduodenectomy between 2001 and 2011 were included in the present multi-institutional study. The degree of HMGB1 expression was examined in each resected specimen by immunohistochemical staining.
A total of 101 patients were enrolled of which, 79 patients were eligible. High expression of HMGB1 was observed in 31 (39%) patients. Blood loss, transfusion, tumor stage, nodal status, and HMGB1 expression were identified as predictors with univariate analysis. Multivariate analysis showed that transfusion, lymph-node metastasis, and high HMGB1 expression were independent predictors of poor overall survival. Subgroup analysis showed that high HMGB1 expression was predictive, especially in patients who did not receive adjuvant chemotherapy.
High HMGB1 expression is an independent predictor of poor prognosis in patients with adenocarcinoma of the ampulla of Vater not treated with adjuvant chemotherapy.
高迁移率族蛋白 B1（HMGB1）是一种多功能蛋白，参与 DNA 功能以及细胞增殖、炎症和免疫反应，其表达已被报道在几种恶性肿瘤中具有预后价值。然而，HMGB1 在壶腹癌中的预后价值尚未得到研究。
本多机构研究纳入了 2001 年至 2011 年间接受胰十二指肠切除术的壶腹腺癌患者。通过免疫组织化学染色检查每个切除标本中 HMGB1 的表达程度。
共纳入 101 例患者，其中 79 例符合条件。31 例（39%）患者观察到 HMGB1 高表达。单因素分析显示，出血量、输血、肿瘤分期、淋巴结状态和 HMGB1 表达是预测因素。多因素分析显示输血、淋巴结转移和 HMGB1 高表达是总生存期不良的独立预测因素。亚组分析显示，HMGB1 高表达是一种预测因子，特别是在未接受辅助化疗的患者中。
未接受辅助化疗的壶腹腺癌患者中 HMGB1 高表达是预后不良的独立预测因子。
