子宫内膜癌患者血清uPA和PAI-1的含量变化及临床意义

目的:探讨子宫内膜癌患者血清尿激酶型纤溶酶原激活物(uPA)及纤溶酶原激活物抑制物-1(PAI-1)含量的变化及其临床意义。方法:用ELISA法测定35例子宫内膜癌(内膜癌组)、18例子宫内膜增生(内膜增生组)和16例正常子宫内膜患者(正常对照组)血清uPA和PAI-1含量及计算两者的比值。结果:内膜癌组患者血清uPA和PAI-1含量及uPA/PAI-1值均显著高于内膜增生组及正常对照组,差异有极显著性(P均<0.01)。内膜增生组及正常对照组,差异无统计学意义(P>0.05)。内膜癌组Ⅲ~Ⅳ期患者血清uPA和PAI-1含量与Ⅰ期相比差异有极显著性(P<0.01),Ⅲ~Ⅳ期患者血清uPA和PAI-1含量高于Ⅱ期(P<0.05),Ⅱ期患者血清uPA、PAI-1含量高于Ⅰ期(P<0.05)。内膜癌组患者血清uPA、PAI-1含量及uPA/PAI-1值随着手术病理分期及组织学分级的增高、肌层浸润深度的增加及淋巴结的转移而升高,差异有显著性(P均<0.05),而与患者病理类型无关(P>0.05)。结论:子宫内膜癌患者血清uPA和PAI-1含量及uPA/PAI-1值明显升高,并与其手术病理分期、浸润转移有关,提示其可能在内膜癌的发生、发展及浸润过程中起重要作用。

Variation and clinical significance of urokinase-type plasminogen activator and plasminogen activator inhibitor-1 in endometrial carcinoma

Objective:To investigate the variation of the plasma concentration of urokinase-type plasminogen activator(uPA) and plasminogen activator inhibitor-1(PAI-1) in endometrial carcinoma and their clinical significence.Method:The levels of uPA and PAI-1 in 35 patients with endometrial carcinoma and 18 endometrial hyperplasia and 16 normals were measured by ELISA.Results:The concentration of uPA and PAI-1 and uPA/PAI-1 in the plasma of endometrial carcinoma patients were significantly higher than that in the plasma of endometrial hyperplasia and normal endometrial patients(P<0.01,respectively).In endometrial hyperplasia patients the levels of plasma uPA and PAI-1 were not significantly higher than those in normal group(P>0.05).uPA and PAI-1 levels in Ⅲ～Ⅳ stage group was statistically higher than those of stage Ⅰ group(P<0.01)and higher than tthose of stage Ⅱ group(P<0.05).uPA and PAI-1 level in stage Ⅱ group was higher than that of stage Ⅰ group(P<0.05).The relative contents increased with the increase of surgical-pathological stage and histological grade(P<0.05,respectively).With the deeper myometrial invasion of endometrial carcinoma,the uPA and PAI-1 levels was increased(P<0.01).More uPA and PAI-1 was ensured in the plasma of patients with lymph metastasis than not(P<0.01).The relative contents of uPA and PAI-1 in the plasma of patients with endometrial carcinoma did not correlate with pathologic type(P>0.05).Conclusion:Levels of uPA,PAI-1 and uPA/PAI-1 increase significantly in the plasma of patients with endometrial carcinoma,and are related to tumor metastasis and prognosis,which indicates they may play an important role in the carcinogenesis and progress of endometrial carcinoma.