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目的:探讨血浆尿激酶型纤溶酶原激活物(urokinase-type plasminogen activator,uPA)、纤溶酶原激活物抑制剂-1(plasminogen activator inhibitor type-1,PAI-1)浓度作为食管鳞状细胞癌预后指标的可能性。方法:收集20例健康人、54例食管鳞状细胞癌患者(手术前、后)及14例术后复发转移患者血浆标本,采用ELISA法测定其血浆uPA、PAI-1浓度,并分析血浆uPA、PAI-1浓度与食管鳞状细胞癌患者临床病理特征的关系。结果:健康人群血浆uPA、PAI-1浓度显著低于食管鳞状细胞癌患者手术前及手术后血浆uPA、PAI-1浓度(P<0.05)。食管鳞状细胞癌患者手术前血浆uPA、PAI-1浓度显著高于术后血浆uPA、PAI-1浓度(P<0.05),显著低于术后复发转移患者血浆uPA、PAI-1浓度(P<0.05)。食管鳞状细胞癌患者血浆uPA、PAI-1浓度与年龄、性别无关,不同性别及年龄组间差异无显著性(P>0.05)。与临床分期有关,临床分期越晚,浓度越高(P<0.05)。与组织分化程度有关,分化程度越低,浓度越高(P<0.05)。与有无淋巴结转移有关,有淋巴结转移组显著高于无淋巴结转移组(P<0.05)。结论:uPA、PAI-1在食管鳞状细胞癌进展过程中发挥重要作用,血浆浓度可作为食管鳞状细胞癌的预后判断指标,浓度升高提示预后不良。
Objective: To investigate the effects of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) on esophageal squamous Possibility of prognosis of cell carcinoma. Methods: Plasma samples of 20 healthy individuals, 54 esophageal squamous cell carcinomas (before and after surgery) and 14 postoperative recurrence and metastasis were collected. The levels of plasma uPA and PAI-1 were measured by ELISA. Plasma uPA , PAI-1 concentration and esophageal squamous cell carcinoma of the clinicopathological features. Results: The plasma levels of uPA and PAI-1 in healthy population were significantly lower than those before and after esophageal squamous cell carcinoma (P <0.05). The levels of plasma uPA and PAI-1 in patients with esophageal squamous cell carcinoma were significantly higher than those in patients with esophageal squamous cell carcinoma (P <0.05), and were significantly lower than those in patients with recurrence and metastasis <0.05). The levels of plasma uPA and PAI-1 in patients with esophageal squamous cell carcinoma were not related to age and gender, and there was no significant difference between different sexes and age groups (P> 0.05). And clinical stage, the clinical stage later, the higher the concentration (P <0.05). With the degree of tissue differentiation, the lower the degree of differentiation, the higher the concentration (P <0.05). With or without lymph node metastasis, lymph node metastasis was significantly higher than without lymph node metastasis (P <0.05). Conclusions: uPA and PAI-1 play an important role in the progression of esophageal squamous cell carcinoma. Plasma concentration can be used as a prognostic indicator of esophageal squamous cell carcinoma, which suggests that the prognosis is poor.