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目的:评估尿激酶型纤溶酶原激活剂(uPA)及其抑制剂(PAI-1、PAI-2)在喉癌中的表达是否具有临床预后价值。方法:通过免疫组化法检测127例喉癌患者uPA、PAI-1、PAI-2的抗原表达情况并经半定量分析结合临床随访,经Kaplan-Meier生存曲线、log-rank检验及Cox比例风险模型分析它们与临床病理参数之间及患者预后的关系。结果:单因素分析表明在传统的预后指标中只有肿瘤细胞的分化状态、淋巴结转移及肿瘤细胞生长方式与预后有关(P<0.05);uPA抗原阳性表达者生存时间缩短,PAI-2阳性表达者预后较好(P<0.01);在T1+2组中uPA阳性者生存率明显降低;uPA-阳性/PAI-2-阴性强烈提示患者预后不佳。经Cox分析发现uPA、PAI-2、淋巴结转移及肿瘤的分化状态是影响喉癌患者生存的独立危险因素。结论:uPA系统在喉癌浸润转移中起着重要的作用,uPA、PAI-2是喉癌患者新的独立的生物学预后指标。uPA有助于评估转移的潜在危险性,并对筛选早期高危险喉癌患者有重要意义。
Objective: To evaluate whether the expression of urokinase-type plasminogen activator (uPA) and its inhibitor (PAI-1, PAI-2) in laryngeal carcinoma has the clinical prognostic value. Methods: The expressions of uPA, PAI-1 and PAI-2 in 127 cases of laryngeal cancer were detected by immunohistochemistry and analyzed by Kaplan-Meier survival curve, log-rank test and Cox proportional hazard ratio The model was analyzed for their relationship with clinicopathological parameters and patient prognosis. Results: Univariate analysis showed that in the traditional prognostic indicators only the differentiation status of tumor cells, lymph node metastasis and tumor cell growth pattern were related to prognosis (P <0.05); the survival time of patients with positive expression of uPA antigen was shorter and PAI-2 positive expression The prognosis was better (P <0.01). The survival rate of uPA-positive patients in T1 + 2 group was significantly lower than that in patients with uPA-positive / PAI-2-negative patients. Cox analysis found that uPA, PAI-2, lymph node metastasis and tumor differentiation status is an independent risk factor for survival of patients with laryngeal cancer. Conclusion: The uPA system plays an important role in the invasion and metastasis of laryngeal carcinoma. UPA and PAI-2 are new independent prognostic indicators in patients with laryngeal cancer. uPA helps to assess the potential risk of metastases and is important for the screening of patients with early-stage high-risk laryngeal cancer.