Upa And Upar Expression In Hypopharyngeal And Laryngeal And Tracheal Flap Is Applied Research In Advanced Hypopharyngeal Repair

Objective:To investigated the expression of urokinase-type plasminogen activator(uPA) and its receptor(uPAR) in squamous cell carcinoma of hypopharynx and revealed the correlation of the major clinicopathologicl parameters and prognosis.Methods: Samples of 48 hypopharyngeal carcinoma and 10 normal hypopharyngeal tissue were detacted by immunohitochemistry method(SABC method) for urokinase-type plasminogen activator (uPA) and its receptor(uPAR). The results were classified positive and negative.The correlation between the expression of urokinase-type plasminogen activator and its receptor and the major clinicopathologicl parameters of hypopharyngeal carcinoma was analyzed by rank sum test and spearman analysis of correlation.Overall survival were analyzed according to Kaplan-Meier and log-rank statistics, the prognostic relevance of uPA and uPAR and conventional prognostic factors were analyzed by Cox's regression model.Results (1) There were no uPA expression in 10 normal hypopharyngeal tissue and 37 uPA expressions in 48 hypopharyngeal carcinoma specimens. The uPApositive expression rate was found 77.1%. There was 1 uPAR expression in 10 normal hypopharyngeal tissue,33 uPAR expressions in 48 hypopharyngeal carcinoma specimens. uPAR positive expression rate was found 68.75%, the uPAR positive rate was significantly higher in hypopharyngeal carcinoma than in normal tissues(P=0.0011).(2)The uPA positive expression was correlated with pathological gradeing, lymph node metastasis and growth mode of hypopharyngeal carcinoma(P=0.007,P=0.0051 and P=0.0401).The uPAR positive expression was correlated with pathological gradeing, lymph node metastasis and growth mode too(P=0.007,P=0.0051 and P=0.0401).The positive expression rate of uPA and uPAR in patients with lower pathological gradeing,lymph node metastasis and invasion growth mode were significantly higher than in patients with higher pathological gradeing, non-lymph node metastasis and non-invasion growth mode.(3) Patients were followed-up prospectively.The uPA and uPAR positive expression were correlated with prognosis(adjust %2=5.26, P=0.0218 and adjust xM 0.0987, P=0.0015).According to Log-rank statistics, patients with uPA and uPAR positive expression had a significantly shorter survival time than those with uPA and uPAR negative expressio^x^^l, P-0.0114 and %2=12.51, P=0.0004).(4) the prognostic relevance of uPA, uPAR and conventional prognostic factors were analyzed by Cox's regression model. Regulated a =0.10,multivariate analysis revealed that three independent prognostic factors for overall survival time were tumor's clinical stage, growth mode and uPAR expression(P=0.0742,P=0.0205 and P=0.0891 respectively).Relative risk and 95% confidence interval were 1.813(0.943 to 3.484),2.885(1.178 to 7.069) and 6.328(0.754 to 53.069)respectively. We concluded that uPAR was new independent and strong biologically prognostic factor, uPAR positive expression may be a powerful aid in evaluating metastatic potential and high risk patients in early stage of hypopharyngeal carcinoma.