Influence of overexpressed coagulant and fibrolytic components in tumor tissues on the prognosis of non-small cell lung cancer

Abstract

To evaluate the expression of tissue factor (TF), urokinase-type plasminogen activator (uPA), and urokinase-type plasminogen activator receptor (uPAR) in non-small cell lung cancer (NSCLC) tissues and to find their roles in lymph node metastasis, vascular involvement and prognosis. Immunohistochemistry was used to examine the expression of TF, uPA, and uPAR in the tumor tissues of 97 NSCLC patients obtained during operation and 40 samples of normal lung tissues at least 5 cm away from the tumor tissues. The correlations of expression of TF, uPA, and uPAR with the clinicopathologic parameters were analyzed by chi2 test. The survival rates were calculated by Kaplan-Meier method. TF, uPA, and uPAR were diffusely expressed in the carcinoma cell cytoplasm with the positive rates of 61.9%, 58.8%, and 61.9% respectively; however, they were only weakly expressed in the scattered macrophage and fibroblast cells in the normal lung tissues. TF expression was correlated with tumor angiogenesis as measured by microvessel density (P < 0.01); TF(34/47), uPA(33/47), and uPAR (39/47) expressions were all positively correlated with lymph node metastasis (P < 0.05, P < 0.05, and P < 0.01), and the uPAR expression was positively correlated with vascular involvement (P < 0.01). The agreement between TF and uPAR expression was significant (r = 0.432, P < 0.01). Co-expression of TF and uPAR was significantly correlated with lymph node metastasis and vascular involvement. Kaplan-Meier survival analysis showed that median the survival time of the patients with TF, uPAR and TF-uPAR positive tumor was shorter than that of the patients with TF, uPAR and TF-uPAR negative tumors (P < 0.01). TF promotes angiogenesis, and uPAR contributes to lymph node metastasis and vascular involvement. Co-expression of TF and uPAR may play an important role in the metastasis and prognosis of NSCLC.