Yamashita J, Ogawa M, Inada K, Yamashita S, Nakashima Y, Saishoji T, Nomura K
Department of Surgery II, Kumamoto University Medical School, Japan.
Br J Cancer. 1993 Feb;67(2):374-8. doi: 10.1038/bjc.1993.68.
Plasminogen activator (PA) is a serine protease which exists in two forms: tissue-type (t-PA) and urokinase-type (u-PA). The total PA activity was measured in tumour extracts of 235 breast cancer patients who were followed for a median of 8.5 years after surgery. Patients were initially divided into three groups with low (< 60 units mg-1 protein), intermediate (60-300 unit mg-1 protein), or high (> 300 unit mg-1 protein) total PA activity in tumour extracts. The PA activity was not significantly associated with the recognised prognostic factors of age, menstrual status, tumour size, lymph node involvement, histologic type, grade of anaplasia, and/or vessel involvement. A significant association was found between total PA activity and the oestrogen receptor (ER) or progesterone receptor (PgR) status. Among receptor-positive tumours, a significantly greater proportion of patients had high PA activity in their tumour extracts. Breast cancer patients with low total PA activity had a significantly shorter disease-free and overall survival rate when compared to those with intermediate or high PA activity. In univariate and multivariate analyses, total PA activity (< 60 unit mg-1 vs > or = 60 unit mg-1 protein) was found to be a significant prognostic factor for disease-free and overall survival of about the same import as lymph node involvement. Furthermore, the combination of total PA activity and nodal status could be even more precise in predicting survival times and probabilities in individual patients. This retrospective study demonstrates the total PA activity is a valuable prognostic factor in determining prognosis in human breast cancer.
纤溶酶原激活剂（PA）是一种丝氨酸蛋白酶，有两种形式：组织型（t-PA）和尿激酶型（u-PA）。对235例乳腺癌患者的肿瘤提取物进行了总PA活性测定，这些患者术后中位随访时间为8.5年。患者最初被分为三组，肿瘤提取物中总PA活性低（<60单位/毫克蛋白质）、中等（60 - 300单位/毫克蛋白质）或高（>300单位/毫克蛋白质）。PA活性与年龄、月经状态、肿瘤大小、淋巴结受累情况、组织学类型、间变程度和/或血管受累等公认的预后因素无显著相关性。发现总PA活性与雌激素受体（ER）或孕激素受体（PgR）状态之间存在显著关联。在受体阳性肿瘤中，肿瘤提取物中PA活性高的患者比例显著更高。与PA活性中等或高的患者相比，总PA活性低的乳腺癌患者无病生存期和总生存期明显更短。在单变量和多变量分析中，发现总PA活性（<60单位/毫克蛋白质与≥60单位/毫克蛋白质）是无病生存期和总生存期的显著预后因素，其重要性与淋巴结受累情况相当。此外，总PA活性和淋巴结状态的组合在预测个体患者的生存时间和概率方面可能更精确。这项回顾性研究表明，总PA活性是确定人类乳腺癌预后的一个有价值的预后因素。
