Ljuca Dzenita, Fatusić Zlatan, Iljazović Ermina, Ahmetović Begzudin
Department of Gynecology and Obstetrics, University Clinical Center Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and Herzegovina.
Bosn J Basic Med Sci. 2007 May;7(2):111-6. doi: 10.17305/bjbms.2007.3063.
In about 70% of cases, ovarian carcinoma has been diagnosed at an advanced stage. Invasion and metastasis of solid tumors request protease activity resulting in basal membrane destruction and surrounding matrix. In that process, urokinase plasminogen activator (uPA) and its receptor, urokinase plasminogen activator receptor (suPAR) play a key role, that via plasmin activation lead to basal membrane and matrix degradation in surrounding of the tumor, enable to its invasion and metastasis. Determination of serum concentration of those tumor markers can be useful in preoperative as well as in postoperative period. Their serum concentrations in ovarian cancer patients may help in good monitoring of remission or progression during chemotherapy treatment. In late 1950s and ear1y 1960s, when it was found out that malignant ovarian tumors were chemosensitive, their chemotherapy treatment has begun. In the beginning it was used only mono-therapy, and by discovering new cytostatics it was replaced by poly-chemotherapy. Now days, in the therapy of advanced stages of ovarian carcinoma combination of cisplatine or carboplatine with paclitaxel is considering as standard treatment. Aim of this study was to determine serum uPA, suPAR and CEA in FIGO II and III patients with different histological type (serous, mucinous, clear cell tumor) before and after PT chemotherapy protocol during following three cycles. In this prospective study we have analyzed 17 patients with ovarian carcinoma, those have been after surgery treated by chemotherapy. Serum levels of uPA and suPAR have been determined by ELISA-test (Imubind uPA, Imubind uPAR, American Diagnostica), and CEA by OPUS Imunoassay method. Results of this study have shown that uPA, suPAR and CEA met criteria for prognostic markers for monitoring of successfulness of platina/taxol chemotherapy protocol for serous, mucinous and clear cell tumor FIGO II and III stage of ovarian carcinoma. In case of PT chemotherapy protocol suPAR was better prognostic marker for monitoring of chemotherapy successfulness (Pearson coefficient 0,9 do 1,0; p<0,00l) than uPA (Pearson coefficient between 0,86 and 0,92; p<0,02) and CEA (Pearson coefficient 0,5 do 0,89; p<0,04).
在大约70%的病例中，卵巢癌在晚期才被诊断出来。实体瘤的侵袭和转移需要蛋白酶活性，从而导致基底膜破坏和周围基质溶解。在这个过程中，尿激酶型纤溶酶原激活剂（uPA）及其受体，尿激酶型纤溶酶原激活剂受体（suPAR）起着关键作用，即通过激活纤溶酶导致肿瘤周围的基底膜和基质降解，使其能够侵袭和转移。测定这些肿瘤标志物的血清浓度在术前和术后都可能有用。它们在卵巢癌患者中的血清浓度可能有助于在化疗期间对缓解或进展进行良好监测。在20世纪50年代末和60年代初，当发现恶性卵巢肿瘤对化疗敏感时，就开始了对其的化疗治疗。起初仅使用单一疗法，随着新的细胞毒性药物的发现，单一疗法被联合化疗所取代。如今，在晚期卵巢癌的治疗中，顺铂或卡铂与紫杉醇的联合被视为标准治疗方法。本研究的目的是在三个周期的PT化疗方案前后，测定国际妇产科联盟（FIGO）II期和III期不同组织学类型（浆液性、黏液性、透明细胞肿瘤）患者的血清uPA、suPAR和癌胚抗原（CEA）。在这项前瞻性研究中，我们分析了17例卵巢癌患者，这些患者术后接受了化疗。uPA和suPAR的血清水平通过酶联免疫吸附测定（ELISA）试验（Imubind uPA，Imubind uPAR，美国诊断公司）测定，CEA通过OPUS免疫测定法测定。本研究结果表明，uPA、suPAR和CEA符合作为监测浆液性、黏液性和透明细胞肿瘤FIGO II期和III期卵巢癌铂/紫杉醇化疗方案成功与否的预后标志物的标准。对于PT化疗方案，suPAR比uPA（Pearson系数在0.86至0.92之间；p<0.02）和CEA（Pearson系数在0.5至0.89之间；p<0.04）是更好的监测化疗成功的预后标志物（Pearson系数为0.9至1.0；p< \0.001）。
