Gandolfo G M, Conti L, Vercillo M
Laboratory of Clinical Pathology, Regina Elena National Cancer Institute, Rome, Italy.
Anticancer Res. 1996 Jul-Aug;16(4B):2155-9.
The impact of prognostic markers on disease-free and overall survival reflects their relative role in tumour biology. Breast cancer and colon carcinoma can be taken as examples to demonstrate the clinical and biological relevance of 'new markers' of neoplastic disease. In breast cancer, receptor-bound urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1 seem to play an important role in the dissolution of the surrounding tissue and the formation of tumour stroma. These processes are prerequisites for invasion and metastasis. The study of 'classical' and 'new' prognostic factors showed that uPA and PAI-1 content of breast cancer tissue are strong and independent prognostic factors. Also in colorectal cancer the prognostic relevance of plasminogen activators and inhibitors was analysed. In particular, low tissue plasminogen activator (tPA) levels, as antigen or as activity, high uPA: tPA antigen ratio in corresponding normal mucosa, high levels of uPA-related antigen and activity and of PAI-2 antigen in neoplastic tissue, and high uPA (neoplastic mucosa): tPA (normal mucosa) ratio, were all parameters associated with a poor overall survival. In conclusion, all these observations show the clinical importance of plasminogen activators and inhibitors at tissue levels with respect to cancer development and survival of patients affected by breast carcinoma or colorectal neoplasia. These new prognostic markers will also permit a better patient selection for a possible adjuvant treatment.
预后标志物对无病生存期和总生存期的影响反映了它们在肿瘤生物学中的相对作用。乳腺癌和结肠癌可作为例子来说明肿瘤性疾病“新标志物”的临床和生物学相关性。在乳腺癌中，受体结合型尿激酶型纤溶酶原激活物（uPA）及其抑制剂PAI-1似乎在周围组织溶解和肿瘤基质形成中起重要作用。这些过程是侵袭和转移的先决条件。对“经典”和“新”预后因素的研究表明，乳腺癌组织中的uPA和PAI-1含量是强有力的独立预后因素。在结直肠癌中也分析了纤溶酶原激活物和抑制剂的预后相关性。特别是，低组织纤溶酶原激活物（tPA）水平（作为抗原或活性）、相应正常黏膜中高uPA:tPA抗原比值、肿瘤组织中高水平的uPA相关抗原和活性以及PAI-2抗原，以及高uPA（肿瘤黏膜）:tPA（正常黏膜）比值，均为与总生存期差相关的参数。总之，所有这些观察结果表明，纤溶酶原激活物和抑制剂在组织水平上对于乳腺癌或结直肠肿瘤患者的癌症发展和生存具有临床重要性。这些新的预后标志物也将有助于更好地选择可能接受辅助治疗的患者。
