A potency of plasminogen activation system in long-term prognosis of endometrial cancer: a pilot study

Abstract

Plasminogen activators released from cancer cells lead to degradation of basement membrane proteins and extracellular matrix, and facilitate cancer cell invasion into surrounding tissues and the blood stream. The aim of this study was to evaluate a complex tissue immunohistochemical expression of the plasminogen activation system--urokinase-type plasminogen activator (uPA) and its receptor (uPAR), tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor (PAI)-1--in endometrial cancer, and to correlate obtained results with disease progression and course. The study group was composed of 100 patients classified in three sub-groups according to the FIGO 2010 tumour stratification (G1=70, G2=19, G3=11). Expression of uPA, tPA, uPAR and PAI-1 was examined by means of immunohistochemical staining. Immunohistochemical expressions of all the studied markers did not differ between G1 and G2 patients. However, G3 subjects were found to have a significantly lower expression of uPA, PAI-1 and tPA. In addition, the patients who survived were found to be PAI-1 negative, while study participants with an unfavourable disease course were PAI-1 positive. A significantly higher immunohistochemical expression of PAI-1 was found to correlate with shorter relapse-free and overall survival in patients classified as stages IB and II of endometrial cancer.