폐암 환자에서 Urokinase Type Plasminogen Activator 및 Plasminogen Activator Inhibitor Type 1의 임상적 의의

Abstract

Cancer invasion and metastasis require the dissolution of extracellular matrix in which several proteolytic enzyme are involved. One of these enzyme the urokinase-type plasminogen activator(u-PA), and plasminogen activator inhibitor type 1(PAI-1) have a possible role in cancer invasion and metastasis by protection of cancer itself from proteolysis by u-PA. It has been reported that the level of u-PA and PAI-1 in various cancer tissues are significantly higher than those in normal tissue and significant correlation with tumor size and lymph node involvement. We measured the concentration of plasma u-PA and PAI-1 antigens in patients with lung cancer and compared the concentration of them with histologic types and staging parameters, and also compared those concentrations in pre-treatment and post-treatment. In this study we measured the concentration of plasma u-PA and PAI-1 antigens using commercial ELISA kit in 40 lung cancer patients and 22 patient with benign lung diseases. The concentration of u-PA was 1.37±0.7 ng/mL in a group of benign lung disease patients and 1.75±0.75 ng/mL in lung cancer patients. The concentration of PAI-1 was 20.86±13.2 ng/mL in benign lung disease and 20.09 ng/mL in lung cancer. The concentration of u-PA in lung cancer patients was higher than those of benign lung disease patients. The concentration of u-PA was 2.42±2.69 ng/mL in lung cancer patients who were not treated, 1.78 ng±0,79 ng/mL in patients who were treated. The concentration of PAI-1 was 19.53±11.75 ng/mL in not-treated lung cancer patients, 10.71±6.26 ng/mL in treated patient group. The concentration of PAI-1 in treated lung cancer patients was lower than those of not-treated lung cancer patients. The concentration of u-PA was 1.82 ng/mL in stage I & Ⅱ, 1.93±0.11 ng/mL in stage Ⅲ, 1.65±0.17 ng/mL in stage Ⅳ. The concentration of PAI-1 was 15.92±5.57 ng/mL in stage I & Ⅱ, 20.95±0.54 ng/mL in stage Ⅲ, 23.99±2.5 ng/mL in stage Ⅳ. The concentration of u-PA was 1.28±0.45 ng/mL in small cell carcinoma, 1.86±0.12 ng/mL in nonsmall cell carcinoma 1.76±0.0 ng/mL in squamous cell carcinoma 1.93±0.2 ng/mL in adenocarcinoma. The concentration of PAI-1 was 18.74±3.83 ng/mL in small cell carcinoma 23.13±3.95 ng/mL in nonsmall cell carcinoma 25.39±2.81 ng/mL in squamous cell carcinoma 20.96±1.62 ng/mL in adenocarcinoma. The plasma levels of u-PA in lung cancer patients were higher than those benign lung disease and plasma level of PAI- 1 in who were treated (surgery, chemotherapy and/or radiotherapy) were lower than those who were not treated. These findings suggest involvement of U-PA with local invasion of lung cancer and possible roles in predicting the prognosis and survival of lung cancer patients.