Immunohistochemical expressions of uPA and its receptor uPAR and their prognostic significant in urinary bladder carcinoma.

BACKGROUND: The authors found previously that plasma levels of urokinase-type plasminogen activator (uPA) and its receptor (uPAR) were elevated in patients with bladder carcinoma and were associated with features of biologically aggressive disease. The present study has been performed to analyze the expressions of two antigens by immunohistochemical staining in bladder transitional cell carcinoma. PATIENTS AND METHODS: The tumors from 72 men and 28 women with a mean age 46.15 years (range 30-67 years) were examined. Paraffin sections of 5 microm thickness were prepared for immunohistochemical staining of uPA and uPAR antigens. Age, sex, tumor grade and stage, DNA ploidy, lymph node status, and metastases were evaluated in relation to outcome. Univariate and multivariate analysis of survival were performed. RESULTS: The overall 5-year survival was 66%. Thirty six and 46 cases were positive for uPA and uPAR expressions, respectively. In univariate analysis, tumor stage, lymph node status, metastases, uPA and uPAR have a significant impact on the survival for these patients. In a Cox proportional hazard model, uPAR sustained its significant impact on survival. CONCLUSIONS: These findings suggest that uPAR is an independent additional prognostic factor in patients with transitional cell carcinoma of the bladder.