Avtor/Urednik     Borštnar, S; Vrhovec, I; Čufer, T
Naslov     Prognostic value of plasminogen activator inhibitors in breast cancer
Tip     članek
Vir     Int J Biol Markers
Vol. in št.     Letnik 17, št. 2
Leto izdaje     2002
Obseg     str. 96-103
Jezik     eng
Abstrakt     The prognosis of cancer is primarily dependent on its potential to invade and metastasize. Data from both preclinical and clinical studies strongly suggest that serine proteases, as well as their inhibitors and receptor, play a central role in the processes leading to metastasis. We therefore investigated the prognostic value of plasminogen activator inhibitors type 1 (PAI-1) and type 2 (PAI-2) and the combination of both inhibitors in 332 patients with operable breast cancer. PAI-1 and PAI-2 content was measured in the primary tumor cytosols using an enzyme-linked immunosorbent assay. For PAI-1 the median value (3.9 ng/mg protein) was used as cutoff, while the optimized cutoff for PAI-2 (6.5 ng/mg protein) was obtained using the log-rank statistic. After a median follow-up of 46 months 96 (29%) patients relapsed. In univariate analysis patients with a high PAI-1 or a low PAI-2 content had an increased risk of relapse. The difference was statistically significant for PAI-1 (p<0.0001) and almost statistically significant for PAI-2 (p=0.057). Stage, tumor size, differentiation grade, lymph node status and hormone receptor status also showed significant univariate impact on disease-free survival (DFS). In multivariate analysis (Cox model) PAI-1 (p<0.0001,RR=2.78), PAI-2 (p=0.0075, RR=2.17), UICC stage (p=0.0014,RR=2.2), differentiation grade (p=0.0097,RR=1.91) and nodal status (p<0.0001, RR=2.9) retained their significance. When both inhibitors were combined the worst prognosis was observed in patients with simultaneous high PAI-1 and low PAI-2 levels, whereas low PAI-1 in combination with high PAI-2 values indicated a very favorable prognosis. In conclusion, our study showed that both PAI-1 and PAI-2 had independent prognostic value in breast cancer. Combination of both inhibitors further improved the differentiation of patients with respect to prognosis.
Deskriptorji     BREAST NEOPLASMS
PLASMINOGEN ACTIVATOR INHIBITOR 1
PLASMINOGEN ACTIVATOR INHIBITOR 2
PROGNOSIS
CYTOSOL
ENZYME-LINKED IMMUNOSORBENT ASSAY
RECURRENCE
NEOPLASM STAGING
DISEASE-FREE SURVIVAL
RECEPTORS, ESTROGEN
RECEPTORS, PROGESTERONE