The Plasminogen Activation System as a Source of Prognostic Markers in Cancer
The components of the plasminogen activation system including the urokinase plasminogen activator, uPA, its cellular receptor, uPAR, and its inhibitor, PAI-1, are involved in cancer invasion and metastasis and our aim was to evaluate their prognostic utility for patients with solid tumors including breast cancer, colorectal cancer, lung cancer, ovarian cancer, and prostate cancer.
Studies reporting the association between uPA, uPAR, and PAI-1 levels and patient outcome have been identified, where samples have been analyzed using quantitative immunoassay platforms. The studies have measured uPA, uPAR, or PAI-1 in either tumor tissue or blood samples.
The identified studies have analyzed the correlation between the levels of uPA, uPAR, and PAI-1 and patient outcome using regression methods. Many of these conclude that there is a statistically significant association between these components and patient survival. Circulating levels of uPAR have been shown to predict outcome in breast cancer, colorectal cancer, ovarian cancer, and prostate cancer. There is evidence that tumor tissue levels of uPAR are not correlated with circulating levels, although both predict outcome. The uPA and PAI-1 levels in breast cancer predict response to adjuvant therapy. For breast cancer, a pooled analysis and a randomized clinical trial have been identified confirming the association between the marker levels and outcome.
The uPA, uPAR, and PAI-1 levels are associated with patient outcome measured in either tumor tissue or blood samples. There is a need for meta-analyses and prospective trials confirming the results in solid tumors with the possible exception of breast cancer where these studies have been performed.
KeywordsOverall Survival Plasminogen Activator Plasminogen Activator Inhibitor Type Urokinase Plasminogen Activator Plasminogen Activator Receptor
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