Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Surgery. 2021 May;169(5):1213-1220. doi: 10.1016/j.surg.2020.11.020. Epub 2020 Dec 26.
BACKGROUND: The aim of this study was to elucidate the correlation of high-mobility group protein A2 overexpression with gastric cancer prognosis and compare its prognostic power with that of pre-existing markers. METHODS: Malignant tissues from 396 patients with gastric cancer who underwent gastrectomy from 2008 to 2012 were examined. High-mobility group protein A2 expression was assessed by immunohistochemistry and the sensitivity and specificity for predicting disease progression and overall survival of high-mobility group protein A2 and the prognostic biomarkers p53, Ki-67, human epidermal growth factor receptor 2, cyclooxygenase-2, and epidermal growth factor receptor were compared. RESULTS: A total of 95 samples (24.1%) showed high-mobility group protein A2 overexpression, which was related to advanced stage, undifferentiated histology, and lymphatic and perineural invasion. Additionally, high-mobility group protein A2 overexpression was an independent prognostic factor in multivariate analysis for disease progression and overall survival. Based on Kaplan-Meier survival analysis disease progression and overall survival, the high-mobility group protein A2-overexpressing patients showed worse survival. The recurrence pattern of peritoneal dissemination was more frequently observed in high-mobility group protein A2-positive group. Moreover, chemoresistance was more frequently observed in the high-mobility group protein A2-positive group. High-mobility group protein A2 exhibited a better ability for predicting disease progression and overall survival than other markers, and the prognostic power was enhanced when high-mobility group protein A2 was used with these markers. CONCLUSION: High-mobility group protein A2 overexpression is associated with chemoresistance and a propensity for carcinomatosis peritonei after surgery in patients with gastric cancer. The power to predict the prognosis of patients with gastric cancer can be enhanced with the use of preexisting biomarkers and high-mobility group protein A2.
背景：本研究旨在阐明高迁移率族蛋白 A2 的过表达与胃癌预后的相关性，并将其与现有标志物的预后能力进行比较。
方法：对 2008 年至 2012 年间接受胃切除术的 396 例胃癌患者的恶性组织进行了检查。通过免疫组织化学评估高迁移率族蛋白 A2 的表达，并比较高迁移率族蛋白 A2 与预测疾病进展和总生存的预后标志物 p53、Ki-67、人表皮生长因子受体 2、环氧化酶-2 和表皮生长因子受体的敏感性和特异性。
结果：共有 95 例（24.1%）样本显示高迁移率族蛋白 A2 过表达，其与晚期、未分化组织学、淋巴和神经周围浸润有关。此外，在多变量分析中，高迁移率族蛋白 A2 过表达是疾病进展和总生存的独立预后因素。基于 Kaplan-Meier 生存分析，疾病进展和总生存方面，高迁移率族蛋白 A2 过表达患者的生存状况较差。在高迁移率族蛋白 A2 阳性组中，更频繁地观察到腹膜播散的复发模式。此外，在高迁移率族蛋白 A2 阳性组中更频繁地观察到化疗耐药。高迁移率族蛋白 A2 对预测疾病进展和总生存的能力优于其他标志物，并且当与这些标志物一起使用时，预后能力得到增强。
结论：高迁移率族蛋白 A2 的过表达与胃癌患者手术后的化疗耐药和腹膜癌播散倾向有关。使用现有标志物和高迁移率族蛋白 A2 可增强预测胃癌患者预后的能力。
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