Research Papers:

HMGB1 overexpression as a prognostic factor for survival in cancer: a meta-analysis and systematic review

Tengyun Wu _, Wei Zhang, Geliang Yang, Huijun Li, Qi Chen, Ruixiang Song and Lin Zhao

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Oncotarget. 2016; 7:50417-50427. https://doi.org/10.18632/oncotarget.10413

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Tengyun Wu1,*, Wei Zhang2,*, Geliang Yang3,*, Huijun Li4, Qi Chen5, Ruixiang Song2, Lin Zhao2

1Air Force General Hospital of Chinese People’s Liberation Army, Beijing 100142, China

2Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China

3Department of Integrated Oncology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China

4The Wright Center, Scranton, Pennsylvania 18510, USA

5Department of Health Statistics, Faculty of Health Service, Second Military Medical University, Shanghai 200433, China

*These authors have contributed equally to this work

Correspondence to:

Tengyun Wu, email: [email protected]

Keywords: high mobility group box 1, cancer, survival, prognosis factor, meta-analysis

Received: November 29, 2015    Accepted: June 12, 2016    Published: July 06, 2016


As there are millions of cancer deaths every year, it is of great value to identify applicable prognostic biomarkers. As an important alarm, the prognostic role of high mobility group box 1 (HMGB1) in cancer remains controversial. We aim to assess the association of HMGB1 expression with prognosis in cancer patients. Systematic literature searches of PubMed, Embase and Web of Science databases were performed for eligible studies of HMGB1 as prognostic factor in cancer. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the influence of HMGB1 expression on overall survival (OS) and progression-free survival (PFS) in cancer patients. 18 studies involving 11 different tumor types were included in meta-analysis. HMGB1 overexpression was significantly associated with poorer OS (HR: 1.99; 95% CI, 1.71-2.31) and PFS (HR: 2.26; 95% CI, 1.65-3.10) irrespective of cancer types including gastric cancer, colorectal cancer, hepatocellular carcinoma, pancreatic cancer, nasopharyngeal carcinoma, head and neck squamous-cell carcinoma, esophageal cancer, malignant pleural mesothelioma, bladder cancer, prostate cancer, and cervical carcinoma. Subgroup analyses indicated geographical area and size of studies did not affect the prognostic effects of HMGB1 for OS. Morever, HMGB1 overexpression had a consistent correlation with poorer OS when detected by immunohistochemistry in tissues and enzyme-linked immunosorbent assay in serum, whereas the correlation did not exist by quantitative real-time reverse-transcription polymerase chain reaction in tissues. HMGB1 overexpression is associated with poorer prognosis in patients with various types of cancer, suggesting that it is a prognostic factor and potential biomarker for survival in cancer.

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