Abstract
The aim of our study was to identify prognostic factors in advanced resectable gastric cancer patients. We investigated 50 advanced gastric cancer surgical specimens by immunohistochemical methods. Measurements of microvessel density, expression of urokinase-type plasminogen activator (u-PA), plasminogen activator inhibitor-1 (PAI-1), urokinase-type plasminogen activator receptor (u-PAR) and vascular endothelial growth factor (VEGF) were made by the streptoavidin-biotin complex staining method. We then compared these parameters with the survival, and clinicopathorogical factors. Microvessel density was between 19.7 and 72.7 (mean 42.7±12.9). Expression of u-PA, PAI-1, u-PAR, or VEGF in cancer cells was detected in 24 (48%), 29 (58%), 28 (56%), and 32 (64%), respectively. Monovariate analysis showed that u-PA expression and microvessel density had a significant influence on survival after surgery. The other two u-PA families had no impact on survival. Ten variables were entered into the Cox proportional hazard regression model to identify factors that independently influenced survival. Multi-variate analysis revealed that clinical stage and the expression of u-PA independently influenced survival in patients. In conclusion, it is suggested that the u-PA expression is useful as a new prognostic factor in advanced gastric cancer patients.
