title: Overexpression of the plasminogen activator inhibitor type-1 in epithelial ovarian cancer.
abstract: BACKGROUND
  The plasminogen activator-plasmin cascade plays a central role in the progression of solid tumors. The type-1 plasminogen activator inhibitor (PAI-1) is the major physiological regulator of plasminogen activation. PAI-1 is suggested to play a crucial role in tumor cell invasion and metastasis of various solid tumors. The aim of this study was to analyze the clinical and prognostic roles of PAI-1 in epithelial ovarian cancer (OC).
  
  
  METHODS
  Expression analysis was conducted by immunohistochemistry and ELISA. Tissue sections of paraffin-embedded tumor specimens and fresh-frozen tumor samples from patients with benign and malignant ovarian tumors (OT), who had undergone surgical intervention in the Department of Gynaecology and Obstetrics, Charité, Germany, from 02/01 to 06/02, were used. Correlation analysis with conventional clinical factors, univariate and multivariate analyses were performed using SPSS (SPSS Inc., V.11.0).
  
  
  RESULTS
  Sixty-five patients (31 primary OC, 20 recurrent OC, 4 low-malignant potential OT, 6 benign OT, 4 normal ovary) were allocated to this trial. The median age was 57 years (range, 34-86) and the median follow-up was 20 months (range, 0-64). The distributions of (FIGO) tumor stage of all primary OC were: I = 16.1%, II = 3.2%, III = 45.2% and IV = 35.5%. PAI-1 was significantly overexpressed in the tumor epithelium of OC in comparison to the ovarian epithelium of benign OT and normal ovary (p < 0.001). The median PAI-1 level was 1.92-fold higher in malignant OT than in benign OT. Statistical analyses showed no significant correlation between the expression of PAI-1 and clinical parameters. The expression of PAI-1 and the PAI-1 level, according to 3 different cut-off values, showed no prognostic impact in univariate analysis. In multivariate analysis, only tumor stage (FIGO) (p = 0.003) and residual tumor (p = 0.009) remained independent prognostic factors for post-operative survival.
  
  
  CONCLUSIONS
  PAI-1 is significantly overexpressed in OC.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Charité, Berlin, Germany. dkonsgen@aol.com
authors.forename: D
authors.initials: D
authors.lastname: Koensgen
authors.forename: A
authors.initials: A
authors.lastname: Mustea
authors.forename: C
authors.initials: C
authors.lastname: Denkert
authors.forename: P M
authors.initials: PM
authors.lastname: Sun
authors.forename: W
authors.initials: W
authors.lastname: Lichtenegger
authors.forename: J
authors.initials: J
authors.lastname: Sehouli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D015999:Multivariate Analysis; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology; D017395:Plasminogen Activator Inhibitor 1 / Q000096:biosynthesis*; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D017395:Plasminogen Activator Inhibitor 1