[Urokinase-type plasminogen activator as a predictor for lymph nodes metastasis of uterine cervical cancer]

The present study was undertaken to assess the role of tumor infiltrating lymphocytes and polymorphonuclear leukocyte-derived human leukocyte elastase (HLE) as an inactivator of urokinase-type plasminogen activator (uPA) activity. We have investigated the localization of pro-uPA/uPA and HLE immunohistochemically and quantitated in paraffin-embedded formalin-fixed uterine cervical cancer tissue sections (stage II) in 13 patients with positive lymph-nodes metastasis and in 16 cases with node-negative. The invasively growing and metastasizing tumor cells consistently contained uPA enzyme activity. When investigated immunohistochemically with antibody to uPA, different parts of individual tumors showed a pronounced heterogeneity in staining intensity. Strong staining was found in the areas with invasive growth and degradation of surrounding normal tissue. A statistically significant higher node-positive rate was observed in patients having tumors with strong uPA stainings than in those with weak stainings. On the other hand, inflammatory cells such as polymorphonuclear cells were located in aggregates or diffusely spread within tumor stromal tissue. The inflammatory reaction seemed to be most intense at the border between the surrounding normal stromas and the tumor tissue. These cells produced and secreted HLE. A statistically significant higher node-positive rate was observed in patients having tumors with weak HLE stainings than in those with strong stainings. Thus, uPA and HLE staining intensities in tissue specimens appear to be independent predictors of increasing and decreasing risk for node-positive, respectively, suggesting that HLE may act as a defence against tumor cell invasion and metastasis.