title: Plasma plasminogen activator inhibitor-1 (PAI-1) levels in breast cancer - relationship with clinical outcome.
abstract: BACKGROUND
  Signaling pathways triggered by increased thrombin or plasminogen activator inhibitor-1 (PAI-1) expression drastically alter the tumor microenvironment, contributing to an adverse outcome. This study aimed to evaluate the prognostic value of coagulation/fibrinolytic activities in breast cancer (BC).
  
  
  METHODS
  Coagulation/fibrinolytic activities were investigated in 187 patients with breast cancer, with respect to possible associations with clinicopathological features and survival outcomes.
  
  
  RESULTS
  Levels of plasma PAI-1 (p<0.001), D-dimer (p=0.037) and activated protein C-dependent thrombin generation (p=0.003) were higher in women with breast cancer compared to 187 healthy women. PAI-1 directly correlated with D-dimer levels (p=0.009) and Ki67 expression (p=0.027), which were both predictors of elevated PAI-1 levels at multivariate regression analysis. Cox analysis demonstrated that an elevated plasma PAI-1 level had a negative prognostic impact in terms of relapse-free (hazard ratio=2.5, p=0.021) and overall survival (hazard ratio=2.7, p=0.002).
  
  
  CONCLUSIONS
  Determination of plasma PAI-1 levels might provide important prognostic information in risk stratification and survival outcomes for patients with breast cancer.
authors.affiliation: Biomarker Discovery & Advanced Technologies (BioDAT) Laboratory, Scientific Institute for Research, Hospitalization and Health Care (IRCCS) San Raffaele Pisana, Via della Pisana 235, 00163, Rome, Italy. ferronipatrizia@gmail.com.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ferroni
authors.forename: Mario
authors.initials: M
authors.lastname: Roselli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Portarena
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Formica
authors.forename: Silvia
authors.initials: S
authors.lastname: Riondino
authors.forename: Francesca
authors.initials: F
authors.lastname: LA Farina
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Costarelli
authors.forename: Antonia
authors.initials: A
authors.lastname: Melino
authors.forename: Gioia
authors.initials: G
authors.lastname: Massimiani
authors.forename: Francesco
authors.initials: F
authors.lastname: Cavaliere
authors.forename: Raffaele
authors.initials: R
authors.lastname: Palmirotta
authors.forename: Fiorella
authors.initials: F
authors.lastname: Guadagni
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000097:blood / Q000401:mortality / Q000556:secondary; D018275:Carcinoma, Lobular / Q000097:blood / Q000401:mortality / Q000556:secondary; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017395:Plasminogen Activator Inhibitor 1
keywords: D-dimer; Plasminogen activator inhibitor-1; breast cancer; overall survival; relapse-free survival