الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 137 |  |  |
| | | from | 137 | | |
Abstract
The plasminogen activation (PA) system comprises several activators, inhibitors, and receptors, all of which have strictly controlled roles. Under physiological conditions, activation of plasminogen to proteolytically active enzyme plasmin takes part in many processes, such as in fibrinolysis, cell migration, wound healing, angiogenesis, tissue destruction, and activation of growth factors and of other proteolytic enzymes. Many of these roles of the PA system in normal physiology are equally important in cancer. Cancer cells need to adhere to basement membranes and subsequently detach from them to be able to move on in the extracellular matrix (ECM). They need to degrade various proteins and maintain their own growth by activating various growth factors and enzymes. Urokinase-type plasminogen activator mediated plasminogen activation facilitated cell migration and invasion through extracellular matrices by dissolving connective tissue components.
In leukemia, the production of normal hematopoietic cells is disrupted, and in the bone marrow, undifferentiated leukemic cells overgrow normal differentiating blood cells. Gradually, these malignant cells burst from the bone marrow into the circulation and in some cases into other organs as well (e.g., skin, gums, and the central nervous system).
The aim of this work was to assess the cell surface uPAR from patients with acute leukemia at initial diagnosis to shed light on the prognostic relevance of this marker in acute leukemia.
The present study was performed on 52 newly diagnosed acute myeloid leukemia patients, 26 male (50%) and 26 female (50%) with an age range of 19 to 83 with a mean of 36.91 ±15.58 years and a median of 40 years.
Among the AML cases, (7) were M1, (14) were M2,(8) were M3 ,(18) were M4, (4) were M5 and (1) was M7.
Cases were diagnosed according to standard methods including morphological, cytochemical and immunological evaluation. The expression of the uPAR was estimated by flow cytometric analysis.
Biological, clinical, laboratory data did not show any statistical significant difference with surface uPAR in acute leukemia patients except hepatomegaly showed significant statistically difference with CD87+ (P=0.023).
uPAR expression was heterogeneous in different FAB subtypes, uPAR was correlated to FAB subtypes as it showed highest expression in monocytic leukemia, CD87 was positive in 20/52 cases of AML patients. The incidence of CD87+ cells in AML (FAB) subtypes was in the following descending order; M4 (12/20, 60%) >M5(4/20, 20%) >M1(2 /20,10%) >M2(1/20, 5%) >M3 (1/20, 5%) >M7(0/20,0%). The highest incidence of CD87+ was found in acute myelomonocytic leukemia and acute monoblastic leukemia (M4/M5).
Correlation of CD87 with cytogenetic results of the patients was statistically insignificant.
Relation between positivity of CD87 and achievement of CR was statistically significant (P=0.001).
Outcome of CD87 positive patients was bad and it was statistically significant (P=0.016).
Survival analysis showed that the patients with CD87 positive expression had significantly shorter OS (median, 30 days) than the patients with CD87 negative expression (median, 90 days) (P = 0.029).