title: Serum high mobility group box-1 (HMGB1) is closely associated with the clinical and pathologic features of gastric cancer.
abstract: BACKGROUND
  High mobility group box-1 (HMGB1) is a newly recognized factor regulating cancer cell tumorigenesis, expansion and invasion. We investigated the correlation between the serum HMGB1 levels and the clinical and pathologic features of gastric cancer and evaluated the validity of HMGB1 as a potential biomarker for the early diagnosis of gastric cancer.
  
  
  METHODS
  A total of 227 subjects were classified into 5 disease groups according to the 'gastritis-dysplasia-carcinoma' sequence of gastric carcinogenesis and their serum levels of HMGB1 were analyzed by an enzyme-linked immunosorbent assay (ELISA) method. Clinical parameters, International Union Against Cancer (UICC) TNM stage, cancer size, differentiation or lymphatic invasion, vascular or perineural invasion and prognosis were used as analysis variables.
  
  
  RESULTS
  The serum HMGB1 levels were significantly different among disease groups (ANOVA, p < 0.05) and HMGB1 levels tended to increase according to the progression of gastric carcinogenesis. Serum HMGB1 levels were significantly associated with depth of invasion, lymph node metastasis, tumor size, and poor prognosis (p < 0.05). However, HMGB1 levels were not associated with patient gender or age, differentiation of tumor cells, or lymphatic, vascular and perineural invasion, or the existence of distant metastasis in advanced cancer (p > 0.05). The sensitivity and specificity of serum HMGB1 was 71% and 67% (cut-off value of 5 ng/ml) for the diagnosis of early gastric cancer, and 70% and 64% (cut-off value of 4 ng/ml) for the diagnosis of high-risk lesions, respectively. These values were greater than those for carcinoembryonic antigen (CEA) (30-40% of sensitivity).
  
  
  CONCLUSIONS
  HMGB1 appears to be a useful serological biomarker for early diagnosis as well as evaluating the tumorigenesis, stage, and prognosis of gastric cancer.
authors.affiliation: Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea. hwchungmd@yumc.yonsei.ac.kr
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Chung
authors.forename: Sang-Guk
authors.initials: SG
authors.lastname: Lee
authors.forename: Heejung
authors.initials: H
authors.lastname: Kim
authors.forename: Duck Jin
authors.initials: DJ
authors.lastname: Hong
authors.forename: Jae Bock
authors.initials: JB
authors.lastname: Chung
authors.forename: David
authors.initials: D
authors.lastname: Stroncek
authors.forename: Jong-Baeck
authors.initials: JB
authors.lastname: Lim
mesh_terms: D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology*; D016019:Survival Analysis
chemical_list: D002272:Carcinoembryonic Antigen; D024243:HMGB1 Protein