Soluble Urokinase Plasminogen Activator Receptor in Preoperatively Obtained Plasma from Patients with Gynecological Cancer or Benign Gynecological Diseases

• Published in: Gynecologic oncology Vol. 82; no. 3; pp. 523 - 531
• Main Authors: Riisbro, R., Stephens, R.W., Brünner, N., Christensen, I.J., Nielsen, H.J., Heilmann, L., von Tempelhoff, G.-F.
• Format: Journal Article
• Language: English
• Published: San Diego, CA Elsevier Inc 01.09.2001; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; CA-125 Antigen - blood; Disease-Free Survival; Endometrial Neoplasms - blood; Endometrial Neoplasms - immunology; Endometrial Neoplasms - pathology; Enzyme-Linked Immunosorbent Assay; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Multivariate Analysis; Neoplasm Staging; ovarian cancer; Ovarian Diseases - blood; Ovarian Diseases - pathology; Ovarian Neoplasms - blood; Ovarian Neoplasms - immunology; Ovarian Neoplasms - pathology; Preoperative Care; progression/relapse-free survival; Receptors, Cell Surface - blood; Receptors, Urokinase Plasminogen Activator; Sensitivity and Specificity; Solubility; soluble urokinase plasminogen activator receptor; Tumors; Uterine Cervical Neoplasms - blood; Uterine Cervical Neoplasms - immunology; Uterine Cervical Neoplasms - pathology; Uterine Hemorrhage - blood; Uterine Hemorrhage - pathology; soluble urokinase plasminogen activator receptor; ovarian cancer; progression/relapse-free survival; Human; Clinical test; Peptidases; Ovary; u-Plasminogen activator; Serine endopeptidases; Enzyme; Female genital system; Hydrolases; Female; Soluble form; Malignant tumor
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.2001.6324

Objective. The present study was planned to measure preoperative levels of soluble urokinase plasminogen activator receptor (suPAR) in plasma from patients with gynecological diseases, and to test for a relationship to clinical and biochemical patient characteristics. Methods. Using a specific and sensitive kinetic ELISA, suPAR levels were determined in preoperative citrate plasma samples from 53 ovarian, 34 endometrial, and 30 cervical cancer patients, 17 patients with benign ovarian tumors, and 28 patients with benign endometrial diseases. In addition, suPAR was measured in citrate samples from 31 female blood donors. Results. suPAR was measurable in all samples. No significant difference was found between plasma suPAR in the blood donors and the patients with benign diseases (P = 0.58). The groups of cancer patients had suPAR levels that were significantly higher than those found in the blood donors (P < 0.0001, P < 0.0001, and P = 0.001 for patients with ovarian, endometrial, and cervical cancer, respectively). In all groups of cancer patients a trend toward increasing suPAR levels with increasing FIGO stage was noted (P = 0.0003, P = 0.02, and P = 0.01 for patients with ovarian, endometrial, and cervical cancer, respectively). Using the median suPAR level to dichotomize the ovarian cancer patients, FIGO stages I–III, a significantly increased risk of progression/relapse was found for patients with high suPAR levels (Hazard ratio (HR) = 3.1, 95% CI: 1.1–8.8, P = 0.03). A multivariate analysis was performed, including suPAR, FIGO stage, and CA-125. Only FIGO stage III compared with FIGO stage I was significant (HR = 15, 95% CI: 1.8–129, P = 0.01). Survival analyses were not performed in the endometrial or cervical cancer patients due to few progressions/relapses during the follow-up period. Conclusion. This study concludes that patients with gynecological cancers have elevated plasma suPAR levels as compared with healthy female blood donors and patients with benign gynecological diseases. In addition, high preoperative plasma levels of suPAR are significantly associated with poor outcome of ovarian cancer patients. However, additional studies are needed to further validate the clinical usefulness of plasma suPAR measurements in the management of ovarian cancer patients.