[Prognostic value of the urokinase-type plasminogen activator and its inhibitors in squamous cell carcinoma of human larynx].
OBJECTIVE
The aim of the present study was to evaluate whether the expression of uPA parameters might be of clinical value in squamous cell carcinoma of human larynx as a tumor/biologically defined risk factor.


METHODS
In a consecutive series of 127 patients resected for primary squamous cell carcinoma of human larynx, the expression of uPA and plasminogen activator inhibitors (PAI) type-1, type-2 was determined immunohistochemically. The results were classified as positive and negative. Patients were followed-up prospectively for a median of 41 months(rang 6 to 84 months). Overall survival were analyzed according to Kaplan-Meier and log-rank statistics, the prognostic relevance of uPA, PAI-1, PAI-2 and conventional prognostic factors were analyzed by Cox analyses.


RESULTS
These revealed a high significant inverse correlation of uPA positive expression survival time(P = 0.006); and patients with PAI-2 positive expression had a significantly longer survival time than those with PAI-2 negative expression(P = 0.009); in different clinicopathological parameters subgroups uPA, PAI-2 added significant survival information, whereas PAI-1 positive expression did not associate with prognoses. Patients with uPA-positive/PAI-2-negative expression had the poorest prognoses. Multivariate analysis revealed that four independent prognostic factors for overall survival time were uPA, PAI-2, lymph node metastasis and differentiation of tumor, P = 0.0002, 0.0001, 0.0117, 0.0436 respectively, relative risk and 95% confidence interval were 1.99 (1.39 to 2.85) 0.36 (0.212 to 0.609), 2.36 (1.21 to 4.61) 1.51 (1.01 to 2.25) respectively.


CONCLUSIONS
We conclude that uPA and PAI-2 are new independent and strong biologically prognostic factors, uPA positive expression may be a powerful aid in evaluating metastatic potential and high risk patients in early stage of human larynx carcinoma.
Zhao
Enmin
E
Department of Otolaryngology-Head and Neck Surgery, the First Hospital of Peking University, Beijing 100034.
Han
Demin
D
Yu
Zhenkun
Z
Fan
Erzhong
E
Li
Ying
Y
Zhou
Zijie
Z
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017395:Plasminogen Activator Inhibitor 1 / Q000096:biosynthesis*; D017396:Plasminogen Activator Inhibitor 2 / Q000096:biosynthesis*; D011379:Prognosis; D015996:Survival Rate; D014568:Urokinase-Type Plasminogen Activator / Q000096:biosynthesis*
D017395:Plasminogen Activator Inhibitor 1; D017396:Plasminogen Activator Inhibitor 2; D014568:Urokinase-Type Plasminogen Activator