Urokinase plasminogen activator: A prognostic marker in multiple types of cancer

Urokinase plasminogen activator (uPA) is a serine protease Causally involve d in cancer invasion and metastasis. Consistent with its role in cancer spr ead, uPA has been shown to be a prognostic marker in a variety of malignanc ies, especially breast cancer. Approximately 20 different groups have shown that high levels of uPA in breast tumor tissue predict poor outcome. As a prognostic marker in breast cancer, uPA provides information that is indepe ndent of traditionally used factors such as tumor size; tumor grade, axilla ry node status and estrogen receptor status. Furthermore, uPA is prognostic in node-negative patients, and a clinical trial is currently under way to assess whether uPA and its inhibitor,. plasminogen activator inhibitor-1, c an differentiate between. the majority of node-negative breast cancer patie nts who are cured by surgery from the minority who might benefit from adjuv ant therapy. uPA is also prognostic in other malignancies, such as gastric, colorectal, esophageal, renal, endometrial, and ovarian cancers. uPA may t hus be a prognostic indicator for multiple types of adenocarcinoma. J. Surg . Oncol. 1999:71:130-135. (C) 1999 Wiley-Liss, Inc.