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目的:探讨尿激酶型纤溶酶原激活物(uPA)、纤溶酶原激活物抑制因子-1(PAI-1)在乳腺癌组织中的表达及其临床意义。方法:免疫组化SP法检测乳腺癌组织及良性乳腺疾病组织中uPA、PAI-1的表达,结合临床病理因素、骨髓微转移状况及随访结果对数据进行统计处理。结果:50例乳腺癌患者癌组织中uPA、PAI-1表达阳性率分别为92.0%和82.0%。与良性乳腺疾病相比,癌组织中两者表达增强,P值均为0.001。癌组织中uPA、PAI-1表达随肿瘤的增大而增高;淋巴结转移阳性者表达强度高;临床分期晚者表达强度高;组织学分级高者表达强度高。ER、PR表达阴性组uPA、PAI-1表达强度较阳性组高,P值均<0.05;c-erbB-2蛋白过表达组uPA、PAI-1表达强度高,P值分别为0.021和0.014;uPA、PAI-1表达强度高者易发生骨髓微转移,且易发生远处转移。uPA与PAI-1的表达呈正相关,r=0.664,P=0.000。结论:乳腺癌组织uPA、PAI-1高表达者发生骨髓微转移及远处转移机会高、预后差,uPA、PAI-1检测可以作为判断乳腺癌预后的指标之一。uPA与PAI-1两者之间存在协同作用。
Objective: To investigate the expression of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor-1 (PAI-1) in breast cancer and its clinical significance. Methods: The expressions of uPA and PAI-1 in breast cancer tissues and benign breast disease tissues were detected by immunohistochemical SP method. The data were statistically analyzed according to clinicopathological factors, bone marrow micrometastasis and follow-up results. Results: The positive rates of uPA and PAI-1 in 50 cases of breast cancer were 92.0% and 82.0% respectively. Compared with benign breast disease, the expression of both in cancer tissue increased, P = 0.001. The expression of uPA and PAI-1 in cancer tissue increased with the increase of tumor; the expression intensity of lymph node metastasis was high; the expression of PAI-1 in late clinical stage was high; The expressions of uPA and PAI-1 in ER, PR negative group were higher than those in positive group, P <0.05, while the expression of uPA and PAI-1 in overexpression of c-erbB-2 protein were high, P values were 0.021 and 0.014, UPA, PAI-1 expression of high susceptibility to bone marrow micrometastasis, and prone to distant metastasis. There was a positive correlation between uPA and PAI-1 expression (r = 0.664, P = 0.000). Conclusion: The high expression of uPA and PAI-1 in breast cancer patients has high chance of bone marrow micrometastasis and distant metastasis, and the prognosis is poor. The detection of uPA and PAI-1 may be one of the prognostic indicators in breast cancer. There is synergy between uPA and PAI-1.