The high mobility group box 1 (
HMGB1) protein functions as an extracellular signaling molecule that is critical in
inflammation and
carcinogenesis. The
HMGB1 protein is actively secreted by natural killer cells, monocytes and macrophages, and acts as an inflammatory
cytokine. The present study enrolled 174 patients that underwent a tumorectomy between 2006 and 2013 in Shandong Provincial Hospital. The age of the patients ranged between 13 and 74 years, with a median age of 27 years. The
tumors of the patients were staged according to the Union for International
Cancer Control 2009
tumor-node-
metastasis tumor staging system. Nuclear grading was based on the Fuhrman grading system. In the
osteosarcoma tissue samples,
HMGB1 expression was detected in 84 samples (48.3%) with a low immunoreactivity and in 90 samples (51.7%) with a high immunoreactivity. The association between clinicopathological characteristics and
tumor cell
HMGB1 expression (low vs. high) was summarized. The association between
HMGB1 expression and
tumor size,
tumor stage and nuclear grade was statistically significant (P=0.034, 0.008 and 0.019, respectively). There was no significant association between
HMGB1 expression and the age of the patients (P=0.335; Table I). The current study demonstrated that patients with a high
HMGB1 expression (>50% cells expressing
HMGB1) had poorer survival rates, and therefore a poorer prognosis, compared with patients with low
HMGB1 immunostaining (10-50% cells expressing
HMGB1). The results of the present study suggest that higher expression levels of
HMGB1 are significantly associated with a poorer prognosis and may act as a marker for prognosis in
osteosarcoma, particularly
osteosarcoma recurrence. Additional studies investigating the biological features of
HMGB1 may confirm the potential role of
HMGB1 as a novel target for anticancer
therapy in
osteosarcoma.