Impact of uPA/PAI-1 and disseminated cytokeratin-positive cells in breast cancer.


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
15 Jul 2019
Historique:
received: 31 10 2018
accepted: 20 06 2019
entrez: 17 7 2019
pubmed: 17 7 2019
medline: 18 12 2019
Statut: epublish

Résumé

The protease uPA and its inhibitor PAI-1 play major roles in hemostasis and are also involved in cancer progression. This is mainly caused by their ability to degrade extracellular matrix-facilitating tumor cell migration. This study aimed to investigate the impact of uPA/PAI-1 and disseminated cytokeratin-positive cells (dCK+) on the outcome and the existence of synergistic effects. We retrospectively analyzed a cohort of 480 breast cancer cases with known uPA/PAI-1 and dCK+ status. uPA/PAI-1 was tested on fresh tumor samples using a commercial ELISA test. Bone marrow aspirates were investigated immunocytochemically for CK18. DCK+ cells were identified in 23% of cases. uPA positivity was significantly associated with the occurrence of dCK+ cells (P = 0.028). uPA and PAI-1 were significantly associated with outcome in the subgroup of early-stage cases without chemotherapy. DCK+ cells alone were not prognostic. However, we found synergistic effects. In the subgroup of node-negative cases with and without chemotherapy, the prognostic impact of uPA and PAI-1 was enhanced in cases with additional dCK-positivity (triple +). In cases without chemotherapy, triple-positive status was independently prognostic (HR: 9.3 CI: 1.1-75) next to T stage. uPA and PAI-1 seem to influence the metastatic potential of dCK+ cells, which underlines its important role in tumor progression.

Sections du résumé

BACKGROUND BACKGROUND
The protease uPA and its inhibitor PAI-1 play major roles in hemostasis and are also involved in cancer progression. This is mainly caused by their ability to degrade extracellular matrix-facilitating tumor cell migration. This study aimed to investigate the impact of uPA/PAI-1 and disseminated cytokeratin-positive cells (dCK+) on the outcome and the existence of synergistic effects.
METHODS METHODS
We retrospectively analyzed a cohort of 480 breast cancer cases with known uPA/PAI-1 and dCK+ status. uPA/PAI-1 was tested on fresh tumor samples using a commercial ELISA test. Bone marrow aspirates were investigated immunocytochemically for CK18.
RESULTS RESULTS
DCK+ cells were identified in 23% of cases. uPA positivity was significantly associated with the occurrence of dCK+ cells (P = 0.028). uPA and PAI-1 were significantly associated with outcome in the subgroup of early-stage cases without chemotherapy. DCK+ cells alone were not prognostic. However, we found synergistic effects. In the subgroup of node-negative cases with and without chemotherapy, the prognostic impact of uPA and PAI-1 was enhanced in cases with additional dCK-positivity (triple +). In cases without chemotherapy, triple-positive status was independently prognostic (HR: 9.3 CI: 1.1-75) next to T stage.
CONCLUSIONS CONCLUSIONS
uPA and PAI-1 seem to influence the metastatic potential of dCK+ cells, which underlines its important role in tumor progression.

Identifiants

pubmed: 31307406
doi: 10.1186/s12885-019-5857-0
pii: 10.1186/s12885-019-5857-0
pmc: PMC6632216
doi:

Substances chimiques

Biomarkers, Tumor 0
Plasminogen Activator Inhibitor 1 0
SERPINE1 protein, human 0
Keratins 68238-35-7
Urokinase-Type Plasminogen Activator EC 3.4.21.73

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

692

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Auteurs

Bruno Märkl (B)

Institute of Pathology, Universitätsklinikum, Stenglinstraße 2, 86156, Augsburg, Germany. bruno.maerkl@lmu.de.

Martin Kazik (M)

Institute of Pathology, Universitätsklinikum, Stenglinstraße 2, 86156, Augsburg, Germany.
Clinic for Anesthesiology and Intensive Care, Universitätsklinikum Augsburg, Augsburg, Germany.

Nadia Harbeck (N)

Brustzentrum, Frauenklinik, Universität München (LMU), Munich, Germany.

Elzbieta Jakubowicz (E)

Institute of Pathology, Universitätsklinikum, Stenglinstraße 2, 86156, Augsburg, Germany.

Reinhard Hoffmann (R)

Institute of Laboratory Medicine and Microbiology, Universitätsklinikum Augsburg, Augsburg, Germany.

Thomas Jung (T)

Clinic for Gynecology and Obstetrics, Universitätsklinikum Augsburg, Augsburg, Germany.

Dieter Steinfeld (D)

Gynecology, Gemeinschaftspraxis Gynäkologische Onkologie, Augsburg, Germany.

Gerhard Schenkirsch (G)

Clinical and Population-based Cancer Registry of Augsburg, Augsburg, Germany.

Günter Schlimok (G)

Hematology and Oncology, Diakonissenkrankenhaus, Augsburg, Germany.

Daniel Oruzio (D)

Onkologische Praxis MVZ, Rehling, Germany.

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Classifications MeSH