Expression of Urokinase-Type Plasminogen Activator and Type 1 Plasminogen Activator Inhibitor in Gastric Cancer with Subserosal Invasion -Predictive Significance for Recurrence in the Liver-

Soichi Tomimatsu, Takashi Ichikura, Shoetsu Tamakuma

First Department of Surgery, National Defense Medical College

The purpose of this study was to determine the correlation between tissue fibrinolytic activity and recurrence in the liver after curative resection for gastric cancer. Among the patients who underwent curative resection for gastric cancer with subserosal invasion, 14 patients who showed recurrence in the liver (RL group) and 30 who survived for five years or longer without any recurrence (control group) were compared clinicopathologically. Paraffin-embedded tissue sections were stained immunohistochemically for urokinase-type plasminogen activator (u-PA) and its inhibitor (PAI-1) by the streptavidin-biotin method. The staining was judged as positive when 10% or more of the cancer cells were stained. Although higher incidences of metastatic involvement in distant nodes and that of moderate and severe lymphatic invasion were observed in the RL group than in the control group, there were no differences in the rate of proliferating cell nuclear antigen positive cells in the cancer and other pathological factors between the groups. The staining for u-PA was positive in 64.3% of the RL group and 40.0% of the control group. The PAI-1 staining was positive in 28.6% of the RL group and 36.7% of the control group. Positive staining for u-PA and negative staining for PAI-1 was observed in 35.7% of the RL group and 6.7% of the control group (p<0.05, chi-square test). Multivariate discriminant analysis revealed that the positive staining for u-PA and negative staining for PAI-1 were useful predictors for hepatic recurrence along with nodal involvement and age at operation. We believe the immunohistochemical staining for u-PA and PAI-1 is a useful predictor for recurrence in the liver after curative resections for gastric cancer.

Key words
gastric cancer, liver metastasis, fibrinolytic activity, urokinase type plasminogen activator, type 1 plasminogen activator inhibitor

Reprint requests
Soichi Tomimatsu First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
March 8, 1995

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