title: Prognostic value of the plasminogen activation system in patients with gastric carcinoma.
abstract: BACKGROUND
  Patients with gastric cancer have a poor prognosis and can be cured by surgery only if the cancer is detected in an early stage. Extended surgery, down staging with chemotherapy before operation, and new postoperative treatments are recent approaches to increase survival rates. Categorizing patients' prognoses as good or poor by pathophysiologic markers, however, may be of great help in selecting therapies for these patients. For example, plasminogen activation (PA) parameters, that play an important role in tumor invasion and metastasis, have prognostic value for several human malignancies.
  
  
  METHODS
  We evaluated the relation between several PA parameters in tissue with standard clinicopathologic parameters and with the overall survival of 50 consecutive patients with gastric carcinoma.
  
  
  RESULTS
  Univariate analysis showed that a low tissue-type plasminogen activator (t-PA) activity in normal mucosa and in carcinomas and a high antigen level of inhibitor type-1 (PAI-1), and, to a lesser extent, of urokinase-type plasminogen activator (u-PA) receptor, in carcinomas are associated with a poor overall survival of the patients. In contrast, of the 14 clinicopathological parameters only the number of eosinophils in the tumors was associated with survival. Multivariate analysis revealed that the t-PA and PAI-1 levels are independently associated with survival.
  
  
  CONCLUSIONS
  Plasminogen activation parameters in both normal and carcinomatous tissue of the stomach of patients with gastric carcinoma are of particular clinical interest because of their prognostic impact on overall survival.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, Leiden, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Ganesh
authors.forename: C F
authors.initials: CF
authors.lastname: Sier
authors.forename: M M
authors.initials: MM
authors.lastname: Heerding
authors.forename: J H
authors.initials: JH
authors.lastname: van Krieken
authors.forename: G
authors.initials: G
authors.lastname: Griffioen
authors.forename: K
authors.initials: K
authors.lastname: Welvaart
authors.forename: C J
authors.initials: CJ
authors.lastname: van de Velde
authors.forename: J H
authors.initials: JH
authors.lastname: Verheijen
authors.forename: C B
authors.initials: CB
authors.lastname: Lamers
authors.forename: H W
authors.initials: HW
authors.lastname: Verspaget
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000032:analysis*; D017396:Plasminogen Activator Inhibitor 2 / Q000032:analysis; D011379:Prognosis; D013274:Stomach Neoplasms / Q000737:chemistry / Q000401:mortality*; D015996:Survival Rate; D010959:Tissue Plasminogen Activator / Q000032:analysis*; D014568:Urokinase-Type Plasminogen Activator / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D017395:Plasminogen Activator Inhibitor 1; D017396:Plasminogen Activator Inhibitor 2; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator