Amplification of the urokinase-type plasminogen activator receptor (uPAR) gene in ductal pancreatic carcinomas identifies a clinically high-risk group.

Abstract

The serine protease urokinase-type plasminogen activator (uPA) and its receptor (uPAR) are known to be involved in the invasion and metastasis of many solid tumors. In this study, we analyzed the role of the uPAR/uPA system in both the development and progression of pancreatic cancer in invasive ductal adenocarcinomas of the pancreas (PDA) and their premalignant precursors (PanIN lesions) in 50 patients with long-term clinical follow-up. We found overexpression of the uPAR in 48 of 50 invasive carcinomas as well as in a large proportion of high-grade PanIN lesions by immunohistochemistry and in situ hybridization. Fluorescence in situ hybridization analysis showed both high- and low-level amplification of the uPAR gene in approximately 50% of cases with strictly identical patterns between invasive cancers and their accompanying precursor lesions. These results suggest that PDA may develop from PanIN lesions along an alternative rather than a sequential molecular pathway. The detection of the gene amplification of uPAR was a highly significant, adverse prognostic parameter (P < 0.001) because it likely renders the tumors more sensitive to uPA and its proproliferative and anti-apoptotic signals. We conclude that the activation of the uPAR/uPA system is an early event in the development of PDA and that uPAR gene amplifications identify a subgroup of particularly aggressive tumors, making the uPAR/uPA system a critical and highly promising target for therapeutic interventions.

• Authors: Ralf Hildenbrand, Marco Niedergethmann, Alexander Marx, Djeda Belharazem, Heike Allgayer, Christiane Schleger, Philipp Ströbel
• Journal: The American journal of pathology (Am J Pathol) Vol. 174 Issue 6 Pg. 2246-53 (Jun 2009) ISSN: 1525-2191 [Electronic] United States
• PMID: 19435784 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Receptors, Urokinase Plasminogen Activator

Topics

• Adult
• Aged
• Apoptosis (physiology)
• Biomarkers, Tumor (analysis)
• Carcinoma, Pancreatic Ductal (genetics, pathology)
• Enzyme-Linked Immunosorbent Assay
• Female
• Gene Amplification
• Humans
• Image Processing, Computer-Assisted
• Immunohistochemistry
• In Situ Hybridization, Fluorescence
• Male
• Middle Aged
• Pancreatic Neoplasms (genetics, pathology)
• Polymerase Chain Reaction
• Precancerous Conditions (genetics)
• Receptors, Urokinase Plasminogen Activator (genetics)
• Risk Factors