DIAGNOSTIC AND PROGNOSTIC VALUE OF PLASMA FIBRINOLYTIC MARKERS IN HEPATOCELLULAR-CARCINOMA

Tissue concentrations of fibrinolytic parameters were used as prognost ic markers for some malignant tumors. To date, these markers have been detected almost exclusively from tissue, which is clinically inconven ient. In the present study, we determined the plasma and tissue concen trations of tissue-type plasminogen activator (tPA), urokinase-type pl asminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1), PAI-2, and uPA receptor (uPAR) in 40 patients with pathologically veri fied hepatocellular carcinoma (HCC); plasma levels of these markers in 27 patients with liver cirrhosis were also measured to find out wheth er these markers could be used to evaluate their prognostic value in p atients with HCC. Plasma tPA and uPA were significantly lower in patie nts with HCC than in cirrhotic individuals. No significant correlation between tissue and plasma concentrations of the same parameters was n oted in patients with HCC. Plasma uPA, tPA, and uPAR were significantl y lower in early-stage HCC than in liver cirrhosis. Plasma PAI-2 was s ignificantly higher in stage IV HCC than in the cirrhotics and most of the other stages of HCC. Fibrinolytic parameters were not affected by tumor size or lymph node involvement, but plasma tPA was significantl y higher in HCC patients with distant metastasis than in patients with out such metastasis. Plasma tPA and, in particular, plasma uPA can hel p in the diagnosis of HCC. Higher plasma PAI-2 might represent later-s tage HCC and thus a poorer prognosis. Plasma uPA, tPA, and uPAR may be used for early diagnosis of HCC. Whether plasma tPA can be used to pr edict distant metastasis in HCC should be investigated further.