Mm. Heiss et al., THE PROGNOSTIC IMPACT OF THE UROKINASE-TYPE PLASMINOGEN-ACTIVATOR SYSTEM IS ASSOCIATED WITH TUMOR DIFFERENTIATION IN GASTRIC-CANCER, European journal of surgical oncology, 22(1), 1996, pp. 74-77
The prognostic value of tumour-associated proteolysis, especially the
urokinase plasminogen activator (uPA) system, has been proposed in gas
tric cancer. In a prospective series of 203 resected patients, the exp
ression of immunohistochemically assessed uPA, uPA-receptors and PAI-I
was strongly associated with survival, Multivariate analysis revealed
PAI-1 as a new independent prognostic factor (overall survival: P=0.0
05, relative risk 1.47, 95% CI 1.31-1.64), Gastric cancer is assumed t
o consist of two biologically different tumour types according to the
histomorphological Lauren's classification, Consideration of this clas
sification revealed strong prognostic impact of the uPA system in diff
use type cancers (overall survival: uPA, P=0.028, relative risk 1.58,
95% CI 1.30-1.91; uPA-receptor, P=0.001, relative risk 1.42, 95% CI 1.
25-1.61) which are by definition low-differentiated (G3), For intestin
al type cancers only in low-differentiated (G3) tumours a prognostic v
alue was obtained (overall survival: PAI-I, P=0.050, relative risk 2.1
6, 95% CI 1.17-3.96) while the association of grading and survival was
not significant, This implies that the clinically relevant impact of
the uPA system is associated with tumour differentiation.