Immunohistochemical analysis of PAI-2 (plasminogen activator inhibitor type 2) and p53 protein in early gastric cancer patients with recurrence: a preliminary report

Background: High levels of urokinase-type plasminogen activator (u-PA) were demonstrated in gastric carcinomas along with inhibitors of plasminogen ac tivators (PAI-1 and PAI-2). They may influence the ability to invade and me tastasize and therefore be of importance to the risk of recurrence of stoma ch neoplasms after curative operation. This also appears to be the case for p53 mutations and p53 protein overexpression. Methods: Six patients, all differentiated cancer cases who developed recurr ent disease 5-10 years after curative operations for early gastric cancers (recurrence group), were studied in comparison with 49 patients who had no recurrence more than 10 years after similar surgery (control group). The ex pression of u-PA, PAI-1, PAI-2 and p53 was compared immunohistochemically i n the recurrence and control groups. Results: The expression of PAI-2 was significantly more frequent in the rec urrence group, being found in five (83.3%) patients vs eight (16.3%) in the control group. p53 was expressed in five (83.3%) patients in the recurrenc e group and in 15 (30.6%) in the control group; the rate was again signific antly higher in the former. Conclusion: The results suggest that PAI-2 and p53 expressed in differentia ted early gastric cancers are possible indices of the risk of recurrence.