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背景与目的:近年研究表明,尿激酶型纤溶酶原激活物(urokinase-typeplasminogen activator,uPA)及其抑制物(plasminogen activator inhibitor,PAI)在肿瘤侵袭、转移过程中起重要作用,但其与上皮性卵巢癌的关系研究甚少。本研究从蛋白水平探讨uPA、PAI-1在上皮性卵巢癌浸润、转移中的作用,组织中的分布情况、及与预后的关系。方法:应用免疫组化法检测80例上皮性卵巢癌、20例良性卵巢肿瘤组织uPA、PAI-1蛋白表达,并结合临床病理因素、预后进行分析。结果:上皮性卵巢癌、良性卵巢肿瘤组织中uPA阳性率分别为77.5%和30.0%(P<0.001),PAI-1阳性率分别为55.0%和20.0%(P=0.005)。上皮性卵巢癌组织中uPA表达与PAI-1表达呈显著性正相关(P=0.001)。uPA阳性与盆腹腔转移病灶直径>1cm有关(P=0.038),与患者年龄、FIGO分期、组织学类型、病理分级、术前血CA125值、卵巢病灶大小、残留病灶大小无显著性相关(P>0.05);PAI-1阳性与FIGO分期有显著性相关(P=0.022),与上述其他临床病理因素无显著性相关(P>0.05)。多因素Cox回归模型显示,uPA表达是肿瘤无进展生存、总生存的独立危险因素;PAI-1表达是总生存的独立危险因素。结论:上皮性卵巢癌组织中uPA、PAI-1表达上调。uPA、PAI-1有可能作为预测上皮性卵巢癌预后的参考指标。
BACKGROUND & AIM: Recent studies have shown that urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor (PAI) play an important role in tumor invasion and metastasis. However, The relationship between epithelial ovarian cancer has little research. In this study, we explored the role of uPA and PAI-1 in the invasion and metastasis of epithelial ovarian cancer, their distribution in tissues and the relationship with prognosis. Methods: The expressions of uPA and PAI-1 protein in 80 cases of epithelial ovarian cancer and 20 cases of benign ovarian tumor were detected by immunohistochemistry, and analyzed with clinicopathological factors and prognosis. Results: The positive rates of uPA in epithelial ovarian cancer and benign ovarian tumors were 77.5% and 30.0%, respectively (P <0.001). The positive rates of PAI-1 were 55.0% and 20.0%, respectively (P = 0.005). The expression of uPA in epithelial ovarian cancer was positively correlated with the expression of PAI-1 (P = 0.001). There was no significant correlation between the level of uPA and the size of residual lesion (P = 0.038), but there was no significant correlation between the level of uPA and the diameter of pelvic cavity metastasis (P = 0.038), the age of the patient, FIGO stage, histological type, > 0.05). There was a significant correlation between PAI-1 positive and FIGO staging (P = 0.022), but no significant correlation with other clinicopathological factors (P> 0.05). Multivariate Cox regression model showed that uPA expression was an independent risk factor for progression-free survival and overall survival of tumor. PAI-1 expression was an independent risk factor for overall survival. Conclusion: The expression of uPA and PAI-1 in epithelial ovarian cancer is up-regulated. uPA, PAI-1 may be used as a predictive prognosis of epithelial ovarian cancer reference index.