Kivonat:
Cathepsin B (CATB) and urokinase-type plasminogen activator (UPA) play an
important part in cancer invasion and metastasis. The behavior of CATB and UPA
has not been evaluated in the same experimental setting in different
gastrointestinal tumors and in precancerous lesions. Serum CATB and plasma UPA
levels were determined by enzyme-linked immunoadsorbent assay and their
sensitivity, specificity, and diagnostic accuracy have been calculated in
patients with colorectal (n=72), gastric (n=30), hepatocellular (n=28), and
pancreatic cancer (n=15) as well as in gastric epithelial dysplasia (n=25),
colorectal adenomas (n=30), and tumor-free control patients (n=44). Serum CATB
and plasma UPA antigen concentrations were significantly higher in patients with
cancer than in controls. When all tumors were considered, the sensitivity,
specificity, and diagnostic accuracy of CATB (89, 86, and 89%) were higher than
that of UPA (76, 70, and 74%). CATB demonstrated in all types of tumors a better
diagnostic accuracy than UPA. The positive predictive values of CATB (95%) and
UPA (89%) may suggest their use in the evaluation of patients with a suspicion of
malignancy. CATB and UPA were significantly higher in patients with gastric
epithelial dysplasia and colorectal adenomas than in controls. Antigen levels of
CATB and UPA were significantly correlated in both cancers and precancerous
lesions. At the time of clinical presentation, serum CATB and plasma UPA antigen
levels are sensitive indicators of gastrointestinal malignancies. Determination
of serum CATB and plasma UPA levels may be useful to identify patients at a
higher risk for progression to cancer, who could be subjected to a more strict
follow-up protocol.