The prognostic value of the soluble urokinase-type plasminogen activator receptor (s-uPAR) in plasma of breast cancer patients with and without metastatic disease

Summary. Elevated levels of soluble uPAR (s‐uPAR) and other fibrinolytic parameters functionally related to the urokinase‐type plasminogen activator system might indicate the presence of cancer cells. In 25 breast cancer patients with metastases s‐uPAR was significantly increased compared with 25 patients without metastases and with 25 healthy controls: 420 pg mL^?1 vs. 145 pg mL^?1 (P = 0.005) and 190 pg mL^?1 (P = 0.003). Plasmin–α₂‐antiplasmin (PAP) complexes and d ‐dimers were significantly increased in breast cancer patients with metastases compared with patients without metastases and with healthy controls. The levels of plasminogen activator inhibitor (PAI)‐1 activity, uPA antigen and factor (F)XIIa did not significantly differ between the patient groups and healthy controls. PAP complexes (529 µg L^?1 vs. 420 µg L^?1; P = 0.03), d ‐dimers (278.5 ng mL^?1 vs. 79.0 ng mL^?1; P = 0.005) and FXIIa (1.64 ng mL^?1 vs. 1.19 ng mL^?1; P = 0.01) were significantly higher in patients with metastases not surviving compared with patients with metastases surviving the 3‐year follow‐up period. Plasma s‐uPAR levels in the patients with metastases did not discriminate between patients surviving and patients not surviving after 3‐year follow‐up. No significant differences in s‐uPAR or any of the other parameters were found in the five patients developing metastases during follow‐up. A single value of s‐uPAR is of limited value in the follow‐up of breast cancer patients with and without metastatic disease and does not predict survival or future metastases.