Local fibrinolytic activity : an index of biological malignancy in digestive tract Cancers

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We examined immunohistochemically the localization of urokinase-type plasminogen activator(u-PA), plasminogen activator inhibitor(PAI)-1 and PAI-2 in both 111cases of gastric and 145 cases of colon cancer.u-PA was immunostained in both gastric(44/111,39.6%)and colon (48/145,33.1%)cancer cells, confirmed the expression of mRNA in cancer cells using in situ hybridization. The expression of u-PA was more marked at the periphery of the tumor rather than in the central area. The five year survival of patients with u-PA positive was significantly lower than that of patients with u-PA negative (51.0% VS 77.5% in gastric cancer, 60.2% VS 80.9% in colon cancer).PAI-1 antigen was detected in fibroblast cells (33/73)surroundings colon cancer cells. In these cases, lymph node metastasis seemed to be lower than that in PAI-1 negative cases. PAI-2 antigen was stained in both gastric (47/111,42.3%)and colon (33/73,45.2%)cancer cells. The intensity of PAI-2 staining was homogenously through the tumor, different pattern with that of u-PA staining. Clinically, u-PA negative and PAI-2 positive cases disclosed relatively well prognosis in five-year survival rate, whereas u-PA positive and PAI-2 negative cases showed poorer prognosis (81.8% VS 26.7% in gastric cancer, 90.9% VS 53.3% in colon cancer).These findings indicates that u-PA is produced by cancer cells themselves, related to cancer invasion and metastasis, presumably useful for an index of biological malignancy, and PAI-1 and PAi-2 may have inhibitory effects in gastric and colon cancer.