Urokinase Plasminogen Activator and Its Inhibitor Type‐1 as Prognostic Factors in Differentiated Thyroid Carcinoma Patients. Issue 4 (8th July 2013)

• Record Type: Journal Article
• Authors: Horvatic Herceg, Gordana; Herceg, Davorin; Kralik, Marko; Kulic, Ana; Bence‐Zigman, Zdenka; Tomic‐Brzac, Hrvojka; Bracic, Irena; Kusacic‐Kuna, Sanja; Prgomet, Drago
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149:Issue 4(2013)
• Page Start: 533
• Page End: 540
• Publication Date: 2013-07-08
• Subjects: urokinase‐type plasminogen activator -- type‐1 plasminogen activator inhibitor -- differentiated thyroid carcinoma -- prognosis -- enzyme‐linked immunosorbent assay; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813496374
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objective: To investigate the prognostic value of urokinase‐type plasminogen activator (uPA) and its inhibitor, type‐1 plasminogen activator inhibitor (PAI‐1), in differentiated thyroid cancer. Study Design: Prospective cohort study. Setting: University hospital. Subjects and Methods: Cytosolic concentrations of uPA and PAI‐1 were determined in 105 patients with differentiated thyroid carcinoma and normal matched tissues using an enzyme‐linked immunoassay (ELISA). Results: Both uPA and PAI‐1 concentrations were significantly higher in differentiated thyroid tumors (uPA = 0.509 ± 0.767 and PAI‐1 = 6.337 ± 6.415 ng/mg) compared to normal tissues (uPA = 0.237 ± 0.051, P <. 001; PAI‐1 = 2.368 ± 0.418 ng/mg, P <. 001). uPA and PAI‐1 were significantly higher if extrathyroidal invasion (uPA, P =. 015; PAI‐1, P <. 001) or distant metastasis (PAI‐1 P <. 001) was present, as well as in tumors whose size exceeded 1 cm in diameter (uPA, P =. 002; PAI‐1, P =. 001). Survival analysis revealed the significant impact of both uPA and PAI‐1 on progression‐free survival (PFS) (82.22 vs 49.478 months for patients with low and high uPA, respectively, P <. 001; 87.068 vs 44.964 months for patients with low and high PAI‐1, respectively, P <. 001). Univariate analysis showed that gender, tumor size, tumor grade, extrathyroid invasion, local lymph node involvement, distant metastasis, uPA, and PAI‐1 were significant predictors of PFS. However, multivariate analysis identified only distant metastasis and tumor tissue uPA and PAI‐1 as independent prognostic factors. Conclusion: These findings indicate that high uPA and PAI‐1 levels represent independent unfavorable prognostic factors in patients with differentiated thyroid carcinoma.