[Urokinase-type plasminogen activator (uPA), uPA receptor (uPA-R) and inhibitors (PA I -1) expression in hepatocellular carcinoma in relation to cancer invasion/metastasis and prognosis].

OBJECTIVE

To study the relevance of uPA, uPA-R and PA I -1 to hepatocellular cancer (HCC).

METHODS

The expression at protein level for uPA, uPA-R and PA I -1 was examined in 48 cases of HCC and 12 cases of benign tumors of the liver (as control) immunohistochemically.

RESULTS

When compared to HCC-adjacent normal liver tissue and the control, positive rates of immune staining for uPA, uPA-R and PA I -1 on cell membrane were significantly higher in HCC cells (P < 0.05). Positive staining of uPA and uPA-R was seen in 16 of 22 and 19 of 22 cases of HCC with invasion, respectively (P < 0.01 and < 0.001). In 8 of 8 cases with cancer emboli, and in 6 of 6 cases with lymph node metastasis was the expression of uPA-R positive. Compared with 2 of 17 cases without recurrence, uPA-R was positive in 15 of 17 recurrent cases (P < 0.01). In 36 cases who survived, 17 was positive for uPA-R and 15 for PA I -1, while in 12 cases who died 2 years after surgery, 12 and 9 cases were positive for uPA-R and PA I -1, respectively (P < 0.01 and < 0.05). In 15 cases positive for all three parameters, 11 had cancer invasion and 7 died in 2 years, while in the controls with negative staining 2 had invasion and none died in 2 years (P < 0.05).

CONCLUSION

Expression of uPA, uPA-R and PA I -1 is increased in HCC, and uPA and uPA-R may contribute significantly to HCC invasion and metastasis. uPA-R and PA I -1 are associated with poor prognosis.