The Relationships Between UPA/PAI-1 And Clinical Pathology Factors And Prognosis In Breast Cancer Tissue

Objective: To detect the uPA and PAI-1 in breast cancer tissue, investigate the relationships between uPA /PAI-1 and clinical pathology factors such as the size of the tumor,clinical stage,the number of metastasis in axillary nodes,tumor histology grade,ER,PR,c-erbB2,bone marrow micro-metastasis(BMM) and prognosis of the patients, also discuss the relationship between uPA and PAI-1. In order to get reliable biological parameter to judge the prognosis of the patients with breast cancer, and to direct individualized treatment.Methods: To choose 50 women patients with primarily breast cancer as experimentation group, who got hospitalization in the 1st surgery department of the 4th hospital of Hebei Medical University between the Oct. 2002 and Oct. 2003. In the same time, choose another 10 patients with innocence disease of breast as contrast. Use immunohistochemistry to detect the uPA and PAI-1 in breast cancer tissue and the contrast group, combine the results to the clinical pathology factors and the follow-up, then statistics the data.Results: About 92.0% positive expression rate of uPA in the malignant group was found, which was defined statistical significance, compared to the innocence group with 10.0% positive expression rate (χ~2=28.360, P=0.001). The expression of uPA was more greatly increased in patients with T2,3 (>2cm) tumors than T1(≤2 cm) (χ~2=13.570, P=0.001) and with clinical stageⅡ,Ⅲ,Ⅳthan stage I (χ~2=8.336, P=0.040). The axillary nodes metastasis positive group had much higher expression of uPA than the negative ones (χ~2=17.381, P=0.001). The expression of uPA in the breast cancer with grade I was lower than that of grade II or III (χ~2=7.585, P =0.023). The ER,PR positive group had much lower expression of uPA than the negative group (χ~2=4.222, P =0.040;χ~2=4.218, P=0.040; respectively), while the c-erbB2 positive group has much higher rate (χ~2=5.329, P=0.021). The high positive expression group of uPA had much higher rate of positive micro-metastasis in bone marrow (χ~2=9.979, P=0.001). There was the correlation between uPA and the distant metastasis or poor prognosis (χ~2=18.752, P=0.001). About 82.0% positive expression rate of PAI-1 in the malignant group was found, which was defined statistical significance, compared to the innocence group with 10.0% positive expression rate (χ~2=17.286, P=0.001). The expression of PAI-1 was more greatly increased in patients with T2,3 (>2cm) tumors than T1(≤2 cm) (χ~2=16.118, P=0.001) and with clinaical stageⅡ,Ⅲ,Ⅳthan stage I (χ~2=8.213, P=0.042). The axillary nodes metastasis positive group has much higher expression of uPA than the negative ones (χ~2=15.353, P=0.001). The expression of uPA in the breast cancer with grade I was lower than that of grade II or III (χ~2=12.482, P=0.002). The ER,PR positive group had much lower expression of uPA than the negative group (χ~2=9.790, P=0.002;χ~2=5.145, P=0.023; respectively), while the c-erbB2 positive group has much higher rate (χ~2=5.992, P=0.014). The high positive expression group of PAI-1 had much higher rate of positive micro-metastasis in bone marrow (χ~2=6.349, P=0.012). There was the correlation between the patients with positive expression of PAI-1 and the distant metastasis or poor prognosis (χ~2=8.470, P=0.004). uPA and PAI-1 had positive relationship with each other(r=0.664, P=0.000).Conclusion: uPA and PAI-1 in breast cancer tissue have relationship with the size of the tumor,the clinical stage,the axillary nodes metastasis,the histology grade of the tumor,the ER,PR,c-erbB2 and the BMM. The most important is that uPA,PAI-1 have positive relationship with each other, the patients with positive expression of uPA,PAI-1 have more chances with distant metastasis and poor prognosis. The detection of uPA,PAI-1 could be as targets to predict the prognosis of breast cancer.