尿激酶型纤溶酶原激活物及其特异受体和抑制物与肺癌的浸润转移

研究尿激酶型纤溶酶原激活物(uPA)及其特异受体(uPA-R)和抑制物(PAI-1、PAI-2)在肺癌浸润转移中的作用.应用RIA分别对67例经组织病理确诊的各期肺癌和30例肺部相关炎症患者及30名健康献血者进行了相应的检测.结果显示,小细胞肺癌Ⅱ期和Ⅲ期患者血浆中uPA、uPA-R、PAI-1水平显著升高(P＜0.001),而PAI-2的水平逐渐降低;腺癌、鳞癌伴有浸润主支气管及肺门淋巴结者uPA、uPA-R与PAI-1水平亦显著升高(P＜0.001);周围型肺癌未见淋巴结受侵者uPA、uPA-R、PAI-1与PAI-2水平异常升高.uPA、uPA-R与PAI-1在肺癌中水平明显升高,并与肺癌的浸润转移相关密切,可作为肿瘤患者早期诊断、预后评估的有力指标.     

LPS促进HUVECs表达纤溶酶原激活物抑制物1

目的：观察LPS对脐静脉血管内皮细胞(HUVECs)表达组织纤溶酶原激活物(tPA)和纤溶酶原激活物抑制物1(PAI-1)的影响。 方法： 用生长良好的第2、3代HUVECs进行试验。用cell counting kit-8(CCK-8)测定LPS刺激后细胞活性变化；发色底物法测定LPS组和对照组培养液中tPA, PAI-1活性；RT-PCR检测细胞内tPA和PAI-1 mRNA水平。 结果： 与对照组相比，LPS(10 mg/L)对细胞活性没有明显差异。LPS诱导PAI-1活性在24-72 h显著升高(P<0.05),且显著上调PAI-1 mRNA，24 h达到峰值，以后渐降，72 h达到正常水平。而LPS组与对照组tPA活性与tPA mRNA无明显差异(P>0.05)。 结论： LPS(10 mg/L)可显著上调PAI-1 mRNA转录和分泌而不影响tPA mRNA，结果提示LPS可活化内皮细胞，诱发PAI-1 mRNA表达和蛋白分泌而抑制纤溶系统，这有利于微血栓的形成、血栓稳定,血液凝固和DIC发生。     

新生大鼠缺氧缺血性脑损伤tPA、PAI-1表达的动态变化

目的:观察新生大鼠缺氧缺血性脑损伤(HIBD)中组织型纤溶酶原激活物(tPA)和1型纤溶酶原激活物抑制剂(PAI-1)表达变化的规律,探讨纤溶系统在缺氧缺血性脑损伤中的作用。方法:7日龄SD新生大鼠96只,随机分为2组:缺氧缺血性脑损伤组和假手术组。两组动物模型制备成功后3、6、12、24、36、48、72、96小时断头取脑,应用免疫组织化学及原位杂交方法检测缺氧缺血性脑损伤不同时间点t-PA、PAI-1表达的变化。结果:假手术组新生大鼠各脑区均有tPA、PAI-1蛋白及mRNA的弱表达,缺氧缺血性脑损伤组不同时间点t-PA、PAI-1二者表达呈不同的动态变化:tPA蛋白及mRNA 3小时开始表达增强,主要见于皮质和海马,神经元表达明显,血管表达较弱,48小时神经元及微血管内皮表达明显增强,72小时神经元表达明显减弱,微血管内皮见有明显阳性表达,之后表达减弱,3～96小时各时间点阳性着色神经元数目显著高于假手术组;PAI-1蛋白及mRNA 12小时表达有所增强,神经元和微血管内皮表达增多,72小时达高峰,12～96小时各时间点阳性着色神经元数目显著高于假手术组。结论:tPA和PAI-1参与HIBD的发病机制。     

多囊卵巢综合征患者血PAI-1和uPA含量的变化

目的观察多囊卵巢综合征(PCOS)患者外周血纤溶酶原激活抑制物1(PAI-1)和尿激酶型纤溶酶原激活物(uPA)的水平。方法实验分PCOS组和对照组,PCOS组又分为肥胖组和正常体重组,用酶联免疫吸附法(ELISA)测定PCOS组与对照组患者血浆PAI-1及血清uPA水平,并测定体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素及胰岛素释放试验(IRT),以稳态模型公式评估胰岛素抵抗(IR),并计算胰岛素曲线下面积(AUC)。结果PCOS组与对照组相比,黄体生成素/卵泡刺激素(LH/FSH)、睾酮(T)、空腹血糖、稳态(HOMA)指数、AUC及PAI-1含量均显著升高(P<0.05)。其中,PCOS肥胖组与正常体重组相比,HOMA指数、AUC及PAI-1含量也显著升高(P<0.05)。在相关性分析中,PAI-1与HOMA指数、PAI-1与AUC、PAI-1与BMI、HOMA-IR与BMI均有显著相关性(P<0.0001)。结论胰岛素抵抗和肥胖是影响PCOS患者PAI-1水平升高的一个很重要因素,抗PAI-1的研究可能为多囊卵巢综合征的治疗提供一个新的方法。     

胰岛素和葡萄糖对缺氧血管内皮细胞分泌tPA和PAI-1抗原的影响

目的: 观察胰岛素和葡萄糖对缺氧血管内皮细胞分泌组织型纤溶酶原激活物(tPA)及其抑制物-1(PAI-1)的影响。 方法:培养人脐静脉内皮细胞株ECV-304。分组实验:(1)常氧组;(2)在缺氧条件下又分为Ⅰ:缺氧对照组;Ⅱ:低浓度组:胰岛素150 mU/L、葡萄糖5.5 mmol/L;Ⅲ:中浓度组:胰岛素450 mU/L、葡萄糖15 mmol/L;Ⅳ:高浓度组:胰岛素900 mU/L、葡萄糖30 mmol/L;Ⅴ:渗透压对照组:甘露醇24.5 mmol/L。取培养4、8、12 h 3个时点,用ELISA法测定细胞培养上清液tPA、PAI-1抗原。结果:缺氧明显增加tPA和PAI-1抗原分泌,tPA/PAI-1值明显增加(P＜0.01)。胰岛素和葡萄糖能够刺激缺氧内皮细胞分泌tPA和PAI-1抗原,在缺氧8 h以内,tPA/PAI-1比值明显增加(P＜0.05)。随缺氧时间的延长,tPA/PAI-1值逐渐下降。结论:胰岛素和葡萄糖能够刺激内皮细胞分泌tPA和PAI-1抗原,在缺氧8 h以内,tPA/PAI-1值升高,纤溶活性升高,有利于局部自发性纤溶的发生。此作用可能是IGK治疗急性心肌梗死的机制之一。     

体外培养的血管内皮细胞低氧低糖损伤后tPA、PAI-1表达变化

目的：观察体外培养的血管内皮细胞低氧低糖损伤后组织型纤溶酶原激活剂(tPA)、Ⅰ型纤溶酶原激活物抑制因子(PAI-1)表达变化，探讨脑缺血后纤溶系统的变化及机制。材料和方法：制备体外内皮细胞低氧低糖损伤模型，利用HE染色、免疫细胞化学染色观察tPA、PAI-1表达变化。结果：低氧低糖损伤后，tPA、PAI-1表达均明显增强。结论：成功制备体外内皮细胞低氧低糖损伤模型。内皮细胞低氧低糖损伤可以诱导tPA、PAI-1表达增多，进一步说明脑缺血损伤后tPA、PAI-1表达增加并参与损伤过程。     

CNSI患者血浆中uPA及其受体（uPAR）的变化和临床意义

目的：研究中枢神经系统感染（CNSI）患者血浆中尿激酶型纤溶酶原激活物（uPA）及其受体（uPAR）的变化及意义。方法：收集我院2006年10月～2008年7月CNSI住院患者69例,将CNSI病例分为病毒性脑炎组、结核性脑膜炎组、化脓性脑膜炎组,并设立对照组。用双抗体夹心酶联免疫法检测所有CNSI病例血浆中uPA及其受体（uPAR）水平。结果：化脓性脑膜炎组、结核性脑膜炎组uPA及其受体（uPAR）水平明显高于病毒组及对照组（P〈0.01）,血浆uPAR浓度改变与uPA同步,但uPAR升高水平高于uPA。结论：血浆中uPA及其受体（uPAR）水平在化脓性脑膜炎、结核性脑膜炎中升高,可为化脓性脑膜炎、结核性脑膜炎、病毒性脑炎的鉴别诊断提供更多的实验室依据。     

登革2型病毒调控血管内皮细胞纤溶系统相关蛋白的表达

目的观察登革2型病毒（DV2）对人脐静脉血管内皮细胞（HUVEC）表达组织纤溶酶原激活物（tPA）和纤溶酶原激活物抑制物1（PAI-1）的影响。方法应用胰酶消化分离HUVEC并进行传代培养，用生长良好的第2．3代细胞进行试验。用cell counting kit-8（CCK-8）测定DV2感染后细胞活性变化；发色底物法测定感染DV2组和对照组培养液中tPA、PAI-1活性；RT-PCR检测细胞内tPA和PAI-1 mRNA水平。结果DV2感染对细胞活力的影响与对照组相比差异无统计学意义。感染DV2组培养液中tPA活性在12～72h显著升高（P〈0．05）；DV2诱导HUVEC表达tPA mRNA的水平显著上调，12h达到峰值，以后渐降，72h mRNA表达水平仍高于对照组（P〈0．01）。而DV2感染组培养液中PAI-1活性和PAI-1 mRNA的表达与对照组比较差异无统计学意义（P〉0．05）。结论DV2感染可显著上调HUVEC的tPA mRNA转录，增强内皮细胞tPA蛋白的分泌，而不影响PAI-1 mRNA的转录或改变内皮细胞PAI-1的分泌。结果提示DV2可活化但并不损伤内皮细胞，诱发内皮细胞增强表达纤溶酶原激活物而致使纤溶系统失衡，引起纤溶亢进，这可能是诱发DHF／DSS患者急性期出血、低血容量性休克等体征的主要因素之一。     

胃癌中uPA、PAI-1表达及其与血管生成的关系

目的 观察胃癌组织中uPA、PAI-1mRNA及蛋白的表达，并探讨它们与肿瘤分化、血管生成及临床病理因素之间的关系。方法 用原位杂交及免疫组化S-P法检测110例胃癌组织中uPA、PAI-1的表达，根据CD34阳性的血管内皮细胞计数肿瘤组织微血管密度（MVD）。结果 （1）胃癌组织中uPA mRNA和蛋白、PAI-1 mRNA和蛋白阳性表达定位于胞质；uPA的表达随分化程度的降低有逐渐升高的趋势，PAI-1的表达随分化程度的降低有逐渐降低的趋势。（2）110例uPA mRNA及蛋白表达阳性组MVD值显著高于阴性组，差异均具有显著性（P值均＜0．05）。（3）uPA mRNA及蛋白的表达与临床分期呈正相关（P＜0．05），PAI-1的表达与临床分期和淋巴结转移无相关性。（4）uPA mRNA／蛋白与PAI-1 mRNA／蛋白的表达无相关性。结论uPA与促进胃癌的血管生成密切相关，阻断uPA的分泌和作用途径有望对胃癌浸润转移起抑制作用；胃癌组织中PAI-1可能担当重要的调节剂或者是肿瘤细胞防止自身降解的保护剂而不是这个系统的单纯抑制剂。     

切应力作用下肾近端小管上皮细胞纤溶酶原激活物(tPA和uPA)表达的变化及意义

检测切应力作用下肾近端小管上皮细胞纤溶酶原激活物tPA和uPA mRNA表达的变化,探讨糖尿病肾病早期小管间质细胞外基质重塑的可能机制.用5 dyn/cm2和10 dyn/cm2的切应力处理肾近端小管上皮细胞(NRK-52E),作用时间分别为1、3和6 h,用RT-PCR法检测tPA及uPA mRNA的表达.结果表明:切应力呈大小和时间依赖性下调肾小管上皮细胞tPA及uPA mRNA的表达.在糖尿病肾病早期,高滤过引起的切应力增加可抑制肾近端小管上皮细胞tPA和uPA mRNA表达,导致肾小管间质纤维蛋白溶解活性降低,参与小管间质细胞外基质的重塑.     

Plasminogen activator system, vascular endothelial growth factor, and colorectal cancer progression.

AIMS: To plasminogen activator system (PAS) consists of the plasminogen activators (urokinase (uPA) and tissue-type (tPA) plasminogen activators), the uPA receptor (uPAR), and the plasminogen activator inhibitors (PAI-1 and PAI-2). Plasminogen activators activate plasminogen to plasmin, which can break down extracellular matrix (ECM) components. Vascular endothelial growth factor (VEGF) is a mitogen for endothelial cells and is involved in angiogenesis. VEGF has been shown to upregulate uPA and this may facilitate tumour angiogenesis further. METHODS: PAS components and VEGF were determined by enzyme linked immunosorbent assay (ELISA) in paired colorectal tumour and normal tissue (n = 50) and correlated with pathological staging. RESULTS: uPA, uPAR, PAI-1, and VEGF values were significantly higher in tumour tissue (for example, tumour uPA: median, 2.3 (range, 0.1-6.7) ng/mg protein v normal uPA: median, 0.2 (range, 0-2.6) ng/mg protein). tPA was significantly higher in normal mucosa and there was no difference in PAI-2. uPA, uPAR, PAI-1, and VEGF values significantly correlated with each other and with Dukes's staging (uPA in adenomas: median, 0.42 (range, 0.1-1.2) ng/mg protein; upA in Dukes's B tumours: median, 2.1 (range, 0.4-4.3) ng/mg protein; and uPA in Dukes's D tumours: median, 4.0 (range, 3.7-4.2) ng/mg protein) and lymphatic invasion. In addition PAI-1 also correlated with tumour size and differentiation. CONCLUSION: The involvement of the PAS and VEGF in colorectal cancer appears to be complex. uPA, uPAR, PAI-1, and VEGF were upregulated in tumour tissue and this correlated with Dukes's staging and lymphatic invasion.     

Induction of the plasminogen activator system by mechanical stimulation of human bronchial epithelial cells

Mechanical stimulation of the airway epithelium, as would occur during bronchoconstriction, is a potent stimulus and can activate profibrotic pathways. We used DNA microarray technology to examine gene expression in compressed normal human bronchial epithelial cells (NHBE). Compressive stress applied continuously over an 8-h period to NHBE cells led to the upregulation of several families of genes, including a family of plasminogen-related genes that were previously not known to be regulated in this system. Real-time PCR demonstrated a peak increase in gene expression of 8.0-fold for urokinase plasminogen activator (uPA), 16.2-fold for urokinase plasminogen activator receptor (uPAR), 4.2-fold for plasminogen activator inhibitor-1 (PAI-1), and 3.9-fold for tissue plasminogen activator (tPA). Compressive stress also increased uPA protein levels in the cell lysates (112.0 versus 82.0 ng/ml, P = 0.0004), and increased uPA (4.7 versus 3.3 ng/ml, P = 0.02), uPAR (1.3 versus 0.86 ng/ml, P = 0.007), and PAI-1 (50 versus 36 ng/ml, P = 0.006) protein levels in cell culture media. Functional studies demonstrated increased urokinase-dependent plasmin generation in compression-stimulated cells (0.0090 versus 0.0033 OD/min, P = 0.03). In addition, compression led to increased activation of matrix metalloproteinase (MMP)-9 and MMP-2 in a urokinase-dependent manner. In postmortem human lung tissue, we observed an increase in epithelial uPA and uPAR immunostaining in the airways of two patients who died in status asthmaticus compared with minimal immunoreactivity noted in airways from seven lung donors without asthma. Together these observations suggest an integrated response of airway epithelial cells to mechanical stimulation, acting through the plasminogen-activating system to modify the airway microenvironment.     

Spitz naevi may express components of the plasminogen activation system

The plasminogen activation (PA) system is involved in the process of invasion and metastasis. Its major components are urokinase (uPA) and tissue-type plasminogen activator (tPA), plasminogen activation inhibitor type 1 and 2 (PAI-1 and PAI-2) and a receptor for urokinase (uPAR). In this study, the expression of plasminogen activation components in Spitz naevi was compared with that in common and dysplastic naevi on the one hand and primary cutaneous melanomas on the other. Spitz naevi had melanocytic positivity for uPA in 0% (0/36), tPA in 30% (6/20), PAI-1 in 10% (3/35), PAI-2 in 40% (8/21) and uPAR in 60% (13/21) of cases. This far exceeded the expression found in common (n = 25) and dysplastic (n = 15) naevi, which only showed melanocytic positivity for PAI-2 (20% and 15% respectively) and in one dysplastic naevus also for uPAR. This was much (for most components significantly) less than the proportion of primary melanomas with tumour cell positivity, which was 30% (11/38) for uPA, 80% (19/24) for tPA, 75% (28/38) for PAI-1, 80% (19/24) for PAI-2 and 80% (19/24) for uPAR. The main findings of this study are that Spitz naevi, firstly, may express plasminogen activator (tPA), inhibitors and the receptor of the PA system, but in a much smaller proportion than cutaneous melanomas; and secondly, do not express urokinase, whereas some of the melanomas do. uPA positivity may therefore be suggestive of melanoma. However, overlapping staining results imply that the PA system has limited value in the differential diagnosis between Spitz naevus and primary melanoma. As serine protease components are expressed, Spitz naevi may use this proteolytic machinery to accomplish matrix degradation, although in a more restricted, possibly transient manner than melanomas.     

Expression of urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor, and plasminogen activator inhibitor-1 and -2 in hepatocellular carcinoma

It has become more and more clear in recent decades that the plasminogen activation system, which includes urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAR), plasminogen activator inhibitor (PAI)-1 and PAI-2, plays a very important role in the aggressiveness of cancer. Using immunohistochemistry and enzyme-linked immunosorbent assay (ELISA), the expression of these four components of the uPA system was analyzed in 19 cases of hepatocellular carcinoma (HCC) and 18 cases of the adjacent non-cancer tissues which all had chronic active hepatitis with liver fibrosis or liver cirrhosis. Four cases of normal liver tissues, as controls for immunohistochemical stains, were obtained from the hepatectomized liver of patients with metastatic cancer in the liver. The positive rates of uPA, uPAR, PAI-1 and PAI-2 for immunohistochemical stains in cancer tissues were 78.9, 68.4, 57.9 and 31.6%, respectively. Positive signals were mainly distributed in the cytoplasm of the cancer and in stromal cells. Moreover, the strong stains were chiefly located in the invasive front of the cancer cells. No specific stain was detected in four cases of normal liver tissues. In ELISA, there were significant differences between cancer and non-cancer tissues in concentration of uPA, uPAR and PAI-1 (P < 0.0003, 0.0024 and 0.01, respectively), but there was no significant difference in that of PAI-2 (P = 0.37). These results suggest that uPA, uPAR and PAI-1 are related to invasion of HCC.     

Immunohistochemical expression of uPA, uPAR, and PAI-1 in breast carcinoma. Fibroblastic expression has strong associations with tumor pathology

The urokinase-type plasminogen activator (uPA) system has been implicated in tumor spread. We have used immunohistochemistry to examine three components of this system, ie, uPA, uPA receptor (uPAR), and plasminogen activator inhibitor-1 (PAI-1), in a pilot study on 142 cases of breast carcinoma. We wished to determine whether there were any relationships between expression of the proteins in either tumor cells or fibroblasts and clinical and pathological features. Strong uPA expression in each cell type was significantly related to high tumor grade (P = 0.013 and 0.008, respectively), and was more common in invasive than in in situ carcinomas (P < 0.0001). Fibroblastic expression of uPAR was only related to the presence of invasion (P < 0.0001). Strong PAI-1 expression in both cell types was seen in high-grade tumors (tumor cells, P = 0.012; fibroblasts, P < 0.001), but only fibroblastic expression was related to the presence of invasion (P = 0.042). Fibroblastic expression of both uPA and uPAR were positively correlated with tumor size. Although patients with strong fibroblastic expression of uPA showed a tendency toward a shorter time to relapse, none of the plasminogen activator proteins were significantly associated with relapse-free survival. These results suggest that strong expression of uPA, uPAR, and PAI-1 in fibroblasts rather than in tumor cells have the most impact on the clinical behavior of breast cancer. Larger prospective studies are needed to confirm these findings.     

In situ localization of mRNA for the fibrinolytic factors uPA, PAI-1 and uPAR in endometriotic and endometrial tissue

Endometriotic tissue grows invasively. The plasminogen-activating system is suggested to participate in degradation of extracellular matrix (ECM) and modulation of cell adhesion and migration. We have previously demonstrated elevated levels of the fibrinolytic factors urokinase plasminogen activator (uPA) and plasminogen activator inhibitor (PAI-1) in endometriotic tissue and endometrium from women with endometriosis. The aim of the present study was to localize the uPA, PAI-1 and urokinase plasminogen activator receptor (uPAR) mRNA in endometriotic tissue and in endometrium both from women with and without endometriosis. With in situ hybridization, we found that uPA mRNA seems to be up-regulated in endometriotic glands and endometrial stroma as well as PAI-1 mRNA in endometriotic and endometrial stroma from women with endometriosis. uPAR mRNA likewise appears to be up-regulated in both glands and stroma in endometriotic tissue and in endometrial glands from patients compared to endometrial glands and stroma from healthy women. These differences might be important for menstrual shedding and adherence of endometrial fragments to peritoneal lining in women developing endometriosis and for the invasive growth of endometriotic tissue.     

Expression of plasminogen activator and inhibitor, urokinase receptor and inhibin subunits in rhesus monkey testes

The expression and localization of mRNA's for tissue plasminogen activator (tPA), urokinase PA (uPA), uPA receptor (uPAR) and inhibin subunits, alpha, beta A and beta B in monkey testes was investigated. Using in-situ hybridization with digoxigenin-labelled cRNA probes (dig- cRNA), we demonstrated that tPA and plasminogen activator inhibitor type 1 (PAI-1) were expressed in testes of both immature and mature rhesus monkeys. tPA mRNA was localized predominantly in Sertoli cells. Expression level was low in immature testis, increased dramatically in the adult and varied with seminiferous cycle. PAI-1 mRNA was localized mainly in germ cells except late spermatids. uPA mRNA was expressed stage-specifically in Sertoli cells of adult testis. uPA receptor mRNA was localized in germ cells of mature testis but not in spermatogonia or late spermatids. Assayed by fibrin overlay technique, PA activity in conditioned media of purified Sertoli cells (Sc) was negligible, PA activity in media obtained from co-cultured Sertoli and Leydig cells (LS), however, was significantly increased, although Leydig cells alone were not capable of producing any PA activity. Addition of follicle stimulating hormone (FSH) to the incubation medium remarkably increased PA secretion in both Sc and LS cultures. Human chronic gonadotrophin (HCG) had no significant effect on PA activity in the Sc culture but dramatically stimulated PA activity in the co-culture system. Dihydrotestosterone (DHT) did not mimic the effect of HCG. PAI-1 activity was secreted mainly by germ cells and did not differ between the two culture systems. FSH and forskolin inhibited PAI-1 secretion. Inhibin alpha, beta A and beta B subunit mRNAs were localized in Sertoli cells of adult monkey testes, with no obvious difference in the expression levels. These data suggest that PA/PAI-1 and other related factors are expressed in rhesus monkey testis under the control of various hormones, seminiferous cycle and cell-cell interactions through paracrine or autocrine regulation. Locally generated fibrinolysis may play an important role in the process of spermatogenesis.      

Plasminogen activator inhibitor-1 as a measure of vascular remodelling in breast cancer

The generation of urokinase plasminogen activator (uPA) by tumours is an important pathway for neoplastic cell invasion and metastasis. Indeed in several tumour types, elevated levels of uPA, its receptor (uPAR) or its inhibitor plasminogen activator inhibitor-1 (PAI-1) is associated with a poorer prognosis. Since endothelial cells also use this proteolytic system to remodel the extracellular matrix during angiogenesis and since angiogenesis, as assessed by microvessel density, is also a predictor of patient survival, this study was designed to investigate the relationship between angiogenesis and the urokinase system in breast tumours. The aims were to assess whether the uPA, uPAR and/or PAI-1 correlates with angiogenic activity and could therefore be a useful objective clinical measure of tumour neovascularization; and to clarify whether the poor outcome associated with high levels of the urokinase system is due to its association with angiogenesis. The study also sought to examine the relationship between the uPA system and vessel remodelling using loss of a basement membrane epitope (LH39) normally associated with established capillaries. The cytosolic levels of uPA, PAI-1 and uPAR were therefore measured by enzyme linked immunoabsorbent assay, together with tumour vascularity, in 136 well-characterized invasive breast carcinomas. There were significant relationships between uPA and uPAR (Spearman r=0.37, p<0.0001), uPA and PAI-1 (Spearman r=0.19, p=0.03) and between uPAR and PAI-1 (Spearman r=0.23 p=0.01). A significant correlation was also observed between PAI-1 and vessel remodelling (Spearman r=0.34, p=0.04), patient age (p=0.01), nodal status (p=0.047) and tumour grade (p=0.04), but no association between tumour vascularity and PAI (p=0.96), uPA (p=0.69) or uPAR (p=0.81) was present. No significant association was seen between any of the urokinase variables and expression of the angiogenic factor thymidine phosphorylase. Furthermore, no significant associations were found between any of the studied parameters and overall survival in a univariate analysis of the cancer patients. A multivariate Cox proportional hazard model of overall survival showed that uPA (p=0.15), but not uPAR (p=0.52) or PAI-1 (p=0.61), gave no additional prognostic information. These findings show that uPA may work via an independent pathway to angiogenesis and therefore combined blockade of uPA and angiogenesis may have additional therapeutic benefits. It also shows, as recently demonstrated in animal models, that PAI-1 may be a key regulator of vascular remodelling in human cancer.     

急慢性乙型肝炎患者血浆uPA和uPAR的检测及意义

目的研究急慢性乙型肝炎uPA和uPAR的表达，探讨肝炎发病时血液纤溶的变化及意义。方法应用酶联免疫吸附试验（ELISA）测定血浆uPA和uPAR的水平。结果急慢性乙型肝炎血浆uPA和uPAR水平与对照组比较均有意义地高于对照组（P〈0．01）；慢性乙型肝炎重度组血浆uPA和uPAR水平显著高于急性乙型肝炎组（P〈0．05），亦显著高于慢性乙型肝炎中轻度组（P〈0．05和P〈0．01）；急性乙型肝炎血浆中uPAR水平显著高于慢性乙型肝炎中轻度组（P〈0．01）；乙型肝炎急性期血浆中uPA和uPAR水平显著升高，恢复期明显回落（P〈0．05和P〈0．01），但仍明显高于正常对照组（P〈0．01）；急慢性乙型肝炎血浆中uPAR水平与凝血酶原时间（PT）（r=0．605，P〈0．01）和国际标准化比率INR（r=0．603，P〈0．01）、胆红素（TB）（r=0．649P〈0．01）呈正相关。结论急慢性乙型肝炎uPA和uPAR水平的升高，与炎症的严重程度有关，与肝细胞损伤程度有关，是肝炎发病时血液凝血和纤溶系统失衡的重要原因之一。