乳腺癌组织和血液中组织型纤溶酶原激活剂及其抑制剂测定的临床意义

Clinical Role of Determining Tissuetype Plasminogen Activator andIts Inhibitor in Plasma and Breast Cancer Tissue

目的：了解纤维蛋白溶解系统在乳腺癌中的作用和临床意义。方法：采用发色底物法检测３０例乳腺癌组织和术前及术后血液中的ｔ－ＰＡ和ＰＡＩ－１活性，并分析其与乳腺癌各病理参数的关系。结果：术前血液中及组织中的ｔ－ＰＡ活性均与乳腺癌的各病理参数无关，而术前血液中及组织中的ＰＡＩ－１活性与腋窝淋巴结转移情况和肿瘤分期有关，且二者之间有显著正相关关系（ｒ＝０．５９１６，Ｐ＜０．０１）。术后血液中的ＰＡＩ－１活性较术前显著降低（Ｐ＜０．０１）。结论：组织中和术前血液中的ＰＡＩ－１活性测定可能有助于判断乳腺癌的腋窝淋巴结转移情况等，以决定治疗方案和选择术后化疗方案，比较术前与术后血液中的ＰＡＩ－１活性有助于判断手术效果。

Chromogenic substrate assay was used to determine the activity of tPA (tissue plasminogen activator) and PAI1 (plasminogen activator inhibitor) in cancer tissue extract and plasma before and after surgery from 30 patient with breast cancer,meanwhile their relationship with pathological parameters were also analysed.It was shown that tPA activity in preoperative blood plasma and cancer tissue extract were not related with pathological parameters,while PAI1 activity was related with axillary lymph node metastasis and tumor staging. There was a positive correlation of PAI1 activity of preoperative blood and that of tissue extract(r=0.5916,P<0.01).The PAI1 activity of blood after operation was significantly decreased than that before(P<0.01).It is suggested that determination of PAI1 activity of cancer tissue extract and blood plasma before operation may help to assess tumor stage and axillary lymph node involvement and in turn, the planning of treatment procedure and adjuvant chemotherapy as well.Comparison of PAI1 activity before and after surgery might predict the effect of surgical intervention.