Serum level of Urokinase Plasminogen Activator (uPA) Correlates with the Survival of Patients with Pancreatic Ductal Adenocarcinoma (PDAC)

Abstract

Background: Urokinase plasminogen activator (uPA) is a serine protease which transforms inactive plasminogen into active plasmin. UPA plays an important role in neoplasm progression, cell growth and metastases through degradation of proteins in basement membranes and extracellular matrix. The aim of the study was the analysis of serum uPA concentration in patients suffering from pancreatic ductal adenocarcinoma (PDAC) and chronic pancreatitis (CP) in order to determine its possible diagnostic and prognostic value. Methods: A study group involved 90 patients: 40 patients with PDAC, 30 patients with CP and 20 healthy individuals. UPA serum concentration was evaluated with ELISA. Results: We observed the threefold increase of uPA serum concentration in patients with PDAC (3,23 ng/ml), twofold increase of uPA serum concentration in patients with CP (2,18 ng/ml) compared to the control group (1,01 ng/ ml) (PDAC vs CP p<0,01; PDAC vs control p<0,01; CP vs control p<0,01). We revealed significant positive correlation between uPA serum level and CA19-9 (r=0.305 p<0,05) in all analyzed groups. We also found the significant correlation between serum uPA concentration and the survival time. Higher uPA concentration was observed in patients with shorter survival time (r=-0,391; p<0,05). Significant differences were present between uPA levels lower and greater than 2 ng/ml and the patients survival time (p<0,05). Conclusions: The presented results confirm the negative prognostic role of high serum uPA concentration in pancreatic cancer patients. The significant positive correlation between uPA serum concentration and CA19-9 provides new insights into the potential role of uPA in pancreatic cancer diagnosis.