Urokinase plasminogen activator (u-PA) versus selected parameters of fibrinolysis in the blood of patients with renal carcinoma
Izabela Iwan-Ziętek, Zbigniew Ziętek
Med Sci Monit 1999; 5(2): CR233-238
The process of fibrinolysis was investigated in 100 patients with renal carcinoma, on the basis of the concentration of urokinase plasminogen activator (uPA), the level of plasmin/antiplasmin complexes (complexes PAP) and the concentration of α2,-antiplasmin (α2,-AP). Additionally, euglobulin lysis time (ELT), the level of fibrin and fibrinogen degradation products (FDP) and the concentration of fibrinogen were determined. Mean concentration of antigen and activity of uPA was much higher in patients with renal carcinoma than in subjects from control group. Likewise, the level of PAP complexes was higher, while there were no significant differences in the activity of α2,-AP. Euglobulin lysis time was shorter in patients with renal carcinoma. The level of FDP was also higher while the concentration of fibrinogen did not differ significantly when compared with control group. Shorter ELT time in patients with renal cancer is the evidence for greater activation of fibrinolysis. Elevated level of PAP complexes reflects increased plasmin generation through the conversion from plasminogen as a result of higher concentrations of urokinase plasminogen activator. Increased FDP level in patients with renal carcinoma is the result of higher fibrin degradation by generated plasmin. Normal level of α2,-AP in patients with renal carcinoma is the evidence for the efficiency of mechanisms controlling fibrinolysis activation, which prevent from the development of haemorrhagic diathesis in the course of uncontrolled activation of fibrinolysis. Investigated parameters of fibrinolysis were analysed depending on the advancement of renal carcinoma. It was demonstrated that the concentration of antigen and activity of uPA, as well as the level of PAP complexes increases along with the advancement of neoplasm. This proves that the advancement of renal cancer and the increase of its mass are accompanied by stronger activation of fibrinolysis caused by increased uPA release from neoplastic cells and the endothelium of pathological vessels. The results obtained indicate that the increase of uPA level is responsible for the elevation of fibrinolytic activity in the plasma of patients with renal carcinoma. uPA comes from neoplastic cells and the endothelium of pathological vessels. Increased fibrinolytic activity carries the risk of the development of haemorrhagic diathesis.
Keywords: renal carcinoma, urokinase plasminogen activator, Fibrinolysis