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The Korean Journal of Pathology 2003;37(6): 384-392.
Expression of Urokinase-type Plasminogen Activator (uPA) and Plasminogen Activator Inhibitor-1 (PAI-1) in Gallbladder Carcinoma.
Kee Hyung Lee, Haeng Ji Kang, Seung Yeoun Lee, Moon Hyang Park
1Department of Pathology, College of Medicine, Hanyang University, Korea. parkmh@hanyang.ac.kr
2Department of Pathology, Seoul Adventist Hospital, Korea.
3Department of Applied Mathematics, College of Natural Sciences, Sejong University, Seoul, Korea.
BACKGROUND: There are evidences that uPA and its inhibitor play a key role in tumor spread. We studied whether uPA and PAI-1 expressions could serve as prognostic parameters along with clinical, gross and microscopic findings in gallbladder carcinomas. METHODS: We analyzed 42 cases of gallbladder carcinomas by immunohistochemical staining and clinicopathologic parameters. RESULTS: uPA and PAI-1 were more frequently expressed in the adenocarcinoma than in the normal or benign gallbladder tissue. The uPA expression in the glands of low grade adenocarcinoma was significantly correlated with both distant and lymph node metastases. The uPA expression in the stroma around the low grade adenocarcinoma was significantly correlated with either distant or lymph node metastasis. The PAI-1 expression was significantly correlated with lymph node metastasis only for both distant and lymph node metastases. In multivariate analysis, the lymphatic invasion was significantly related to poor survival (p= 0.0115). In univariate analysis, the cases without lymphatic invasion had prolonged survival. Positive expression of uPA in the glands of low-grade adenocarcinoma was significantly correlated with poor survival (p=0.0391). CONCLUSION: In conjunction with clinicopathologic findings, expressions of uPA and PAI-1 may be useful prognostic markers in gallbladder carcinomas.
Key Words: Urokinase; Type Plasminogen Activator; Plasminogen Activator Inhibitor 1; Gallbladder Neoplasmsx; Prognosis