A High Cytosol Value of Urokinase-Type Plasminogen Activator (uPA) May Be Predictive of Early Relapse in Primary Breast Cancer

Abstract

Background: There is now much data that suggest a relationship between angiogenesis and breast cancer prognosis. Angiogenesis is a multistep process resulting from an ordered set of events and regulated by positive and negative modulators of microvessels growth and by the expression of various proteolytic enzymes. Materials and methods: We prospectively evaluated VEGF and microvessels density on tumor specimen and cytosolic levels of uPA and PAI-1. Results: We enrolled 81 primary breast cancer patients. The median follow-up was 38 months. Using the median value as cutoff for the statistical analysis, we found significant correlation between cytosolic levels of uPA and PAI-1(r=0.61;p<.0001), between VEGF and steroid hormone receptor status(p=.01), between PAI-1 and tumor grading(p=.009), and between uPA and tumor size greater than 1 cm(p=.04). With respect to the prognosis, we observed a significant correlation between low uPA levels and RFS and an unforeseen, direct correlation between high VEGF values and better RFS. Conclusions: Our preliminary results indicate that the cytosolic level of uPA at diagnosis may be predictive of early relapse in primary breast cancer.

• Angiogenesis
• PAI-1
• Primary breast cancer
• Prognostic factors
• uPA
• VEGF