Soluble urokinase plasminogen activator receptor in preoperatively obtained plasma from patients with gynecological cancer or benign gynecological diseases

Objective. The present study was planned to measure preoperative levels of soluble urokinase plasminogen activator receptor (suPAR) in plasma from pat ients with gynecological diseases, and to test for a relationship to clinic al and biochemical patient characteristics. Methods. Using a specific and sensitive kinetic ELISA, suPAR levels were de termined in preoperative citrate plasma samples from 53 ovarian, 34 endomet rial, and 30 cervical cancer patients, 17 patients with benign ovarian tumo rs, and 28 patients with benign endometrial diseases. In addition, suPAR wa s measured in citrate samples from 31 female blood donors. Results. suPAR was measurable in all samples. No significant difference was found between plasma suPAR in the blood donors and the patients with benig n diseases (P=0.58). The groups of cancer patients had suPAR levels that we re significantly higher than those found in the blood donors (P<0.0001, P<0 .0001, and P=0.001 for patients with ovarian, endometrial, and cervical can cer, respectively). In all groups of cancer patients a trend toward increas ing suPAR levels with increasing FIGO stage was noted (P=0.0003, P=0.02, an d P=0.01 for patients with ovarian, endometrial, and cervical cancer, respe ctively). Using the median suPAR level to dichotomize the ovarian cancer pa tients, FIGO stages I-III, a significantly increased risk of progression/re lapse was found for patients with high suPAR levels (Hazard ratio (HR)=3.1, 95% CI: 1.1-8.8, P=0.03). A multivariate analysis was performed, including suPAR, FIGO stage, and CA-125. Only FIGO stage III compared with FIGO stag e I was significant (HR=15, 95% CI: 1.8-129, P=0.01). Survival analyses wer e not performed in the endometrial or cervical cancer patients due to few p rogressions/relapses during the follow-up period. Conclusion. This study concludes that patients with gynecological cancers h ave elevated plasma suPAR levels as compared with healthy female blood dono rs and patients with benign gynecological diseases. In addition, high preop erative plasma levels of suPAR are significantly associated with poor outco me of ovarian cancer patients. However, additional studies are needed to fu rther validate the clinical usefulness of plasma suPAR measurements in the management of ovarian cancer patients. (C) 2001 Academic Press.