华中科技大学同济医学院附属武汉中心医院 胃肠外科，湖北 武汉 430000
王向阳， Email: email@example.com
Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
背景与目的 核转录因子HMBOX1在不同肿瘤中有不同的表达模式，且与胶质瘤、卵巢癌、胃癌及肝细胞癌预后密切相关。但是，目前尚未见HMBOX1在结直肠癌中的表达及与预后的关系的报道，故本研究探讨结直肠癌组织中HMBOX1的表达及与预后的关系。方法 收集2012年1月—2014年1月行结直肠癌切除术的90例患者癌组织标本及临床资料，采用免疫组化染色检测结直肠癌组织中HMBOX1表达，并根据免疫组化结果分为HMBOX1高表达组与HMBOX1低表达组，分析两组临床病理特征的与预后差异，并分析影响结直肠癌术后患者无瘤生存率和总生存率的危险因素。结果 HMBOX1高表达组54例（60.0%），HMBOX1低表达组36例（40.0%）。HMBOX1高表达与TNM分期、N分类、M分类及分化程度明显有关（均P<0.05），与年龄、性别和T分类无明显关系（均P>0.05）。HMBOX1高表达组1、3、5年无瘤生存率与1、3、5年总生存率均明显低于低表达组（均P<0.05）。单因素分析显示，III~IV期、N2、M1及HMBOX1高表达为影响无瘤生存率的危险因素，多因素分析表明，III~IV期、M1及HMBOX1高表达是影响无瘤生存率的独立危险因素（均P<0.05）。单因素分析显示，III~IV期、M1、低分化及HMBOX1高表达为影响总生存率的危险因素，多因素分析表明，III~IV期、低分化及HMBOX1高表达是影响总生存率的独立危险因素（均P<0.05）。结论 在结直肠癌中，HMBOX1的表达与恶性生物学指标密切相关，HMBOX1的表达可作为结直肠癌患者术后预后评估的因素，HMBOX1高表达者预后不良。
Background and Aims Nuclear transcription factor homeobox containing protein 1 (HMBOX1) has different expression patterns in different tumors. And it is closely related to the prognosis of glioma, ovarian cancer, gastric cancer and hepatocellular carcinoma. However, the expression of HMBOX1 and its prognostic significance in colorectal cancer have not been study. Therefore, this study was conducted to investigate the expression of HMBOX1 in colorectal cancer and its relationship with prognosis.Methods The cancer tissue specimens and clinical data of 90 patients who underwent colorectal cancer resection from January 2012 to January 2014 were collected. The expression of HMBOX1 in colorectal cancer tissue was detected by immunohistochemical staining. According to the results of immunohistochemistry, the tissues were divided into high HMBOX1 expression group and low HMBOX1 expression group. The differences in clinicopathologic characteristics and prognosis were analyzed, and the risk factors influencing the postoperative tumor-free survival rate and overall survival rate of colorectal cancer patients were also determined.Results There were 54 (60.0%) cases in high HMBOX1 expression group and 36 (40.0%) cases in low HMBOX1 expression group. The high expression of HMBOX1 was significantly associated with TNM stage, N classification, M classification and histological differentiation (all P<0.05), but irrelevant to age, sex and T classification (all P>0.05). The 1-, 3- and 5-year disease-free survival rates and 1-, 3- and 5-year overall survival rates in high HMBOX1 expression group were all significantly lower than those in low HMBOX1 expression group (all P<0.05). Univariate analysis showed that III-IV stage, N2, M1 and high HMBOX1 expression were influencing factors for tumor-free survival rate, and multivariate analysis revealed that III-IV stage, M1 and high HMBOX1 expression were independent risk factors for tumor-free survival (all P<0.05). Univariate analysis showed that III-IV stage, M1, poor differentiation and high HMBOX1 expression were influencing factors for overall survival, and multivariate analysis revealed that III-IV stage, low differentiation and high HMBOX1 expression were independent risk factors for overall survival (all P<0.05).Conclusion In colorectal cancer, the expression of HMBOX1 is closely related to the malignant biological properties. It can be used as an index for postoperative prognostic prediction of colorectal cancer patients, and those with high HMBOX1 expression may face a unfavorable prognosis.