Urokinase-type plasminogen activator and its inhibitor PAI-1 as prognostic factors in cervical cancer

Objective: To analyze the prognostic value of urokinase-type plasminogen activator (uPA) and its specific inhibitor PAI-1 in surgically treated cervical cancer. Methods: uPA and PAI-1 were measured by ELISA in the supernatant of tissue extracts of 86 cervical cancers and 35 tumor-free control tissue samples. Results: Median concentrations of uPA and PAI-1 were significantly higher in the tumors than in the control tissue (0.12 vs. 0.01 and 1.5 vs. 0.07 ng/mg protein, respectively; p < 0.001) and in stage pT2b than in stage pT1b disease (0.22 vs. 0.10 ngl mg, p < 0.01, and 3.03 vs. 0.90 ng/mg, p < 0.05, respectively). PAI-1 levels correlated with tumor volume (r [s] = 0.38; p < 0.01). After a median follow-up of 30 months patients with PAI-1 levels > 4.52 ng/mg had a shorter survival than those with PAI-1 levels < 4.52 ng/mg (p < 0.05). uPA levels did not correlate with the prognosis. Conclusions: PAI-1 may be a prognostic factor in patients with surgically-treated cervical cancer.