Author/Editor		Borštnar, Simona; Čufer, Tanja; Vrhovec, Ivan; Rudolf, Zvonimir
Title		Prognostic relevance of urokinase plasminogen activator and its inhibitors in patients with breast cancer
Translated title		Napovedni pomen urokinaznega aktivatorja plazminogena in njegovih inhibitorjev pri bolnicah z rakom dojk
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 33, št. 1
Publication year		1999
Volume		str. 43-53
Language		eng
Abstract		Urokinase plasminogen activator (uPA) and its inhibitors, PAI-1 and PAI-2, play an important role in iritercellular tissue degradation, thus promoting tumor cell invasion into the adjoining structures and metastasizing. Our study was aimed to assess a possible prognostic value of uPA, PAI-1 and PAI-2 in a retrospective series of 87 patients with breast cancer stage I-III, whose cytosols were stored in the archives of the, Institute of Oncology in Ljubljana. The median follow-up was 35 months. The prognostic value of the established prognostic factors and uPA, PAI-1 and PAI-2 were evaluated by means of univariate statistical analysis and partial multivariate models. The obtained uPA values were very low and did not correlate with the disease free survival, whereas PAI-1 and PAI-2 significantly influenced the time to the first recurrence. Patients with PAI-1 values above 5 ng/mg proteins had statistically significantly worse disease free survival than the patients with lower PAI-1 values (58% vs. 85%). In the case of PAI-2, the situation was just the opposite: the patients with PAI-2 values exceeding 6.4 ng/mg proteins had statistically significantly better 3-year disease free survival than the patients with lower values (90% vs. 60%). Both, PAI-1 and PAl-2 retained their independent prognostic value, irrespective of the addition of the established prognostic factors to partial multivariate models, and only with locally advanced disease the prognostic value of PAI-1 was greater than that of PAI-2.
Summary		Urokinazni aktivator plazminogena (u-PA), in njegova inhibitorja (PAI- 1 in PAI-2) igrajo pomembno vlogo pri razgradnji medceličnega tkiva in s tem pri prodoru tumorskih celic v okolico ter metastaziranju. Namen naše raziskave je bil ugotoviti morebitno napovedno vrednost uPA, PAI-1 in PAI-2 v retrospektivni seriji 87 bolnic z rakom dojke stadijev I-III, njihove citosole hranimo na Onkološkem inštitutu v Ljubljani. Srednja opazovalna doba je bila 35 mesecev. Napovedni pomen uveljavljenih napovednih dejavnikov ter uPA, PAI-1 in PAI-2 smo ocenjevali z univariatno statistično analizo in delnimi multivariatnimi modeli. Vrednost uPA so bile zelo nizke in niso korelirale s preživetjem brez znamenj bolezni, PAI-1 in PAI-2 pa sta značilno vplivala na čas prve ponovitve bolezni. Bolnice, ki so imele vrednost PAI-1 večjo od 5ng/mg pro- teinov, so imele statistično značilno slabše preživetje brez znamenj bolezni kot bolnice z manjšimi vrednostmi (58% vs 85% , p = 0.0046). PAI-2 je pokazal nasprotno sliko, bolnice z vred- nostmi PAI-2 večjimi od 6.4 ng/mg proteinov so imele statistično značilno boljše triletno preživetje brez znamenj bolezni kot bolnice z manjšimi vrednostmi ( 90% vs 48%, Ir= 0.0178). PAI-1 in PAI-2 sta ohranila svojo neodvisno napovedno vrednost ob dodajanju uveljavljenih napovednih dejavnikov v delne multivariatne modele in le lokalna razširjenost bolezni je pokazala večjo napovedno moč od PAI-1 in PAI-2.
Descriptors		BREAST NEOPLASMS UROKINASE PLASMINOGEN ACTIVATOR INHIBITOR 1 PLASMINOGEN ACTIVATOR INHIBITOR 2 PROGNOSIS RECURRENCE