[Expression and clinical significance of uPA and PAI-1 in epithelial ovarian cancer].

BACKGROUND & OBJECTIVE: Recent researches showed that urokinase-type plasminogen activator (uPA) and its inhibitor, plasminogen activator inhibitor (PAI)-1, play an important role in the invasion and metastasis of solid tumors. However, their correlations to epithelial ovarian cancer have seldom been reported. This study was to investigate the roles of uPA and PAI-1 in the invasion and metastasis of epithelial ovarian cancer, to clarify their localization and relationship with prognosis. METHODS: Immunohistochemistry was applied to examine the protein expression of uPA and PAI-1 in 80 specimens of epithelial ovarian cancer and 20 specimens of benign ovarian tumor. The correlations of their expression to the clinicopathologic characteristics and prognosis of the patients were analyzed. RESULTS: The positive rates of uPA and PAI-1 were significantly higher in epithelial ovarian cancer than in benign ovarian tumor (77.5% vs. 30.0%, P<0.001; 55.0% vs. 20.0%, P=0.005). uPA expression was correlated positively to PAI-1 expression in epithelial ovarian cancer (P=0.001). Higher positive rate of uPA was associated with greater metastatic tumor in the peritoneal cavity (P=0.038), but not associated with age, FIGO stage, histological type, pathologic grade, serum CA125 level, ovarian tumor size, and the size of residual tumor (P>0.05). Higher positive rate of PAI-1 was associated with early FIGO stage (P=0.022), but not associated with other parameters (P>0.05). Multivariate analysis showed that uPA was an independent factor for progression-free survival and overall survival, and PAI-1 was an independent factor for overall survival. CONCLUSION: Both uPA and PAI-1 are up-regulated in epithelial ovarian cancer, and might be used as markers to predict the prognosis of epithelial ovarian cancer patients.