Analysis Of The Correlation Of HMGB1 And Primary Epithelial Ovarian Cancer

Objective To determinate the expression of high mobility group box l(HMGB1) in primary epithelial ovarian cancer(EOC) tissue, and investigate the correlation of HMGB1 and clinical factors in EOC, to provide guidance to predict disease progress and prognosis of EOC patients.Methods Research Objects were the patients who accepted surgery in Department of Gynecology and were diagnosed primary epithelial ovarian cancer definitely by pathological diagnosis in Xinhua Hospital affiliated to Shanghai Jiaotong university school of medicine from January 2010 to June 2013. We carried out a retrospective study of the clinical factors, such as, patient’s age of onset, pathological type, FIGO stages, cell differentiation, the size of the primary lesions, quality of ascities, preoperative serum CA125 level, and so on. Immunohistochemistry(IHC) staining was performed to investigate the expression of HMGB1. Finally, we analyzed the expression of HMGB1 in EOC tissue and the correlation of HMGB1 and the above clinical factors.Results HMGB1 predominantly distributed in the nucleus of a cell and also weakly expressed in the cytoplasm and outside the cells. The overall positive rate of HMGB1 was as high as 91.25%(73/80), and the strong positive rate was 35.0%(28/80). By univariate analysis, the positive rate of HMGB1 in FIGO advanced group was higher than in FIGO early group(82.2% vs 37.1%), the positive rate of HMGB1 in poor cell differentiation group was higher than in well and moderate cell differentiation group(80.0% vs 28.6%), the positive rate of HMGB1 in malignant ascites group was higher than in benign ascites group(88.1% vs 34.2%), the positive rate of HMGB1 in preoperative serum CA125≥200U/ml group was higher than in CA125<200U/ml group(80.9% vs 42.1%), differences were statistically significant in the above factors(P<0.05). However, there was not significant difference in positive expression rate of HMGB1 when grouped by patient’s age of onset, pathological type, size of theprimary lesions(P>0.05).Conclusion 1. HMGB1 was high-expressed in primary ovarian cancer, and HMGB1 was mainly located in the nucleus of a cell and weakly expressed in the cytoplasm and outside the cells. 2. The positive expression of HMGB1 was related to the FIGO advanced stages, poor cell differentiation, malignant ascites and high level preoperative serum CA125, HMGB1 could be used to predict the disease progression and prognosis of patients in epithelial ovarian cancer.Objective In the primary EOC patients with platinum combined paclitaxel(TP) as first-line chemotherapy, we analyzed the relationship between HMGB1 and TP first-line drug sensitivity, to provide guidance for clinical chemotherapy.Methods Research Objects were the patients with Platinum combined paclitaxel as first-line chemotherapy regimens selected from the primary EOC patients in part one. They were divided into TP resistance type and TP sensitive type according to recurrence interval once chemotherapy completion. The expression of HMGB1 in EOC tissue was measured by IHC, then patients were divided into low HMGB1 expression group and high HMGB1 expression group according to the expression degree, rate differences were compared by Chi-squared test, investigated the relationships between the expression of HMGB1 and the sensitivity of TP first-line chemotherapy.Results The TP first-line drug resistance rate was 42.25%(30/71) in primary EOC,TP first-line drug resistance rate was 71.43%(25/35) in HMGB1 high expression group, and 13.89%(5/36) in HMGB1 low expression group, TP first-line drug resistance rate in HMGB1 high expression group was obviously higher than in HMGB1 low expression group, there was statistical significance between the two groups( x2=24.08, P<0.01).Conclusion The TP first-line drug resistance rate was 40.85%(29/71) in primary EOC, the high expression of HMGB1 was associated with TP first-line resistance, HMGB1 might be a molecule to predict TP first-line drug sensitivity before chemotherapy in EOC.Objective Analyzed the relationship between the expression of HMGB1 and the overall survival(OS) in primary EOC Patients, to provide guidance to evaluate the prognosis of patients.Methods Research Objects were the same to the patients in part two. Patients were followed up by letters or phone calls, Follow-up details contained the patient’s survival time and the general situation(such as, relapse or not, physical condition, diagnosis and treatment continuing or not, and so on). The survival curve of patients were traced by Kaplan-Meier survival analysis and tested by Log-rank, the average of measurement data was compared by t test, investigated the OS difference between HMGB1 high expression and HMGB1 low expression group in the whole patients, in TP resistance patients and in TP sensitivity patients.Results In the whole patients, the OS of HMGB1 high expression group was obviously shorter than low expression group(Log-rank=17.87). The average OS ofHMGB1 high expression group was obviously shorter than HMGB1 low expression group(21.8 vs 35.0 months) in TP resistance group, the average OS of HMGB1 high expression group was obviously shorter than expression group low(27.2 vs 36.9 months) in TP sensitivity group.Conclusion The expression level of HMGB1 had an influence on the OS of EOC patients, HMGB1 high expression maybe an important factor leading to OS shorten in EOC patients, it brought EOC patients a poor prognosis.