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A retrospective study of urokinase-type plasminogen activator receptor (uPAR) as a prognostic factor in cancer of the uterine cervix

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Abstract

Background

Hypoxia occurs during the development of uterine cervical cancer and is considered to correlate with its invasion. Hypoxia promotes both the invasiveness and the metastasis of cancer cells through urokinase-type plasminogen activator receptor (uPAR) expression. The aim of this study was to evaluate the correlation between uPAR mRNA level and clinical prognostic factors of uterine cervical cancer.

Methods

We performed a retrospective review of 59 patients with cervical cancer and 9 subjects with normal cervical tissues. Total RNA was isolated from tissues of the uterine cervix surgically removed from patients. The mRNA of uPAR could be measured by real time PCR (RT-PCR). Histopathological factors such as histopathological type, cervical stromal, parametrial, lymphovascular, and uterine corpus invasions, metastasis to the pelvic lymph nodes, and pTNM stage were confirmed by two pathologists. The examined prognostic factors alongside the histopathological ones were FIGO clinical stage, hemoglobin level, serum level of SCC, and the effect on clinical outcomes. These factors were statistically evaluated by Fisher’s exact test, log-rank test, and ROC analysis. Immunohistochemical staining with anti-uPAR monoclonal antibody was also performed.

Results

In uterine cervical cancer, overexpression of uPAR mRNA was significantly related to shorter disease-free survival (p = 0.0396). However, the other clinical prognostic and histopathological factors were not related to uPAR mRNA expression level. Immunohistochemical staining showed that positive staining for uPAR was histologically localized on the membrane of carcinoma cells. However, the staining was not very intense.

Conclusions

Overexpression of uPAR mRNA may be a prognostic factor in cancer of the uterine cervix.

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Acknowledgments

The authors are indebted to Medical English Service (27, Yoshidatachibanacho, Sakyo-ku, Kyoto, Japan) for their editorial review of this manuscript. The authors thank Ms. Chinatsu Yonekawa (Department of Obstetrics and Gynecology, Tokyo Medical University) for invaluable experimental assistance.

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Hirotaka Nishi.

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Sasaki, T., Nishi, H., Nagata, C. et al. A retrospective study of urokinase-type plasminogen activator receptor (uPAR) as a prognostic factor in cancer of the uterine cervix. Int J Clin Oncol 19, 1059–1064 (2014). https://doi.org/10.1007/s10147-014-0664-8

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  • DOI: https://doi.org/10.1007/s10147-014-0664-8

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