Soluble urokinase-type plasminogen activator receptor and ferritin concentration in patients with advanced alimentary tract carcinoma. Relationship to localization, surgical treatment and the stage of the disease--preliminary report.

BACKGROUND The urokinase plasminogen activation system is associated with metastatic potential of cancer in several tumors. Its specific membrane receptor (uPAR) is released from cancer cells and can be detected as the soluble fraction of the plasminogen activator receptor (suPAR). Ferritin (FRT) is a poor prognostic factor in various neoplasms. OBJECTIVES We analyzed the serum concentrations of suPAR and FRT in patients with gastrointestinal cancer. Tumor localization, stage of the disease, possibility of surgery and histopathological diagnosis were considered. MATERIAL AND METHODS The analysis involved 48 patients (8 females/40 males) treated in the Department of Gastrointestinal and General Surgery, Wroclaw Medical University. Thirty two patients had esophageal, 7-gastric, 9-colorectal cancer. Fifteen patients underwent resection surgery, 33 palliative therapy. The control comprised 10 healthy donors. The serum concentration of suPAR was determined by enzyme-linked immunosorbent assay (ELISA), expressed in pg/mL. Concentration of the serum FRT was detected using immunonephelometry method, expressed in µg/L. RESULTS Serum concentration of suPAR ranged from 1789-7320, x=3676.2, SD=1042 and was significantly higher (p=0.0002) than in the control group. In patients who underwent palliative therapy, the concentration of suPAR was significantly higher (p=0.05) than in those after resection, also in patients with esophageal cancer compared to those with colorectal one (p=0.02). Serum concentration of FRT in patients with gastrointestinal cancer was significantly higher than in control group. Serum FRT concentration was higher in patients with esophageal cancer compared to patients with gastric cancer (p=0.05), in persons with IV compared to patients with I-III stage of the disease, patients who underwent palliative compared to surgical therapy. CONCLUSIONS In patients with gastrointestinal cancer the level of suPAR is high, with highest values in advances disease with remote metastases. The FRT concentration is sensitive indicator of the disease process: its level is highest in pts with IV stage who underwent palliative therapy.