Journal
CLINICA CHIMICA ACTA
Volume 439, Issue -, Pages 84-90Publisher
ELSEVIER
DOI: 10.1016/j.cca.2014.10.004
Keywords
Cancer biomarker; Urokinase receptor; Reference intervals; Age- and gender-dependent variation; Colorectal cancer; Time-resolved fluorescence immunoassay
Categories
Funding
- Danish Cancer society [R40-A1771-11-S2]
- Axel Muusfeldt Foundation
- Copenhagen University Hospital [140382-XXXX/632-01]
- Lundbeck Foundation [R54-A5392]
- Aase and Ejnar Danielsen Fund
- Aage and Johanne Louis-Hansen Fund
- Walter and O. Kristiane Christensen Fund
- Sophus and Astrid Jacobsen Fund
- Arvid Nilsson Fund
- Glunz and Jensen Fund
- Friedrich and Else Boehm Fund
- Agnes and Poul Friis Fund
- Eva and Henry Fraenkel Fund
- Hartmann Bros. Fund
- Willy and Ingeborg Reinhard Fund
- Katrine and Vigo Skovgaard Fund
- Oda and Hans Svenningsen Fund
- Einar Willumsen Fund
- Kornerup Fund
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Background: High levels of circulating forms of the urokinase-type plasminogen activator receptor (uPAR) are significantly associated to poor prognosis in cancer patients. Our aim was to determine biological variations and reference intervals of the uPAR forms in blood, and in addition, to test the clinical relevance of using these as cut-points in colorectal cancer (CRC) prognosis. Methods: uPAR forms were measured in citrated and EDTA plasma samples using time-resolved fluorescence immunoassays. Diurnal, intra- and inter-individual variations were assessed in plasma samples from cohorts of healthy individuals. Reference intervals were determined in plasma from healthy individuals randomly selected from a Danish multi-center cross-sectional study. A cohort of CRC patients was selected from the same cross-sectional study. Results: The reference intervals showed a slight increase with age and women had -similar to 20% higher levels. The intra- and inter-individual variations were similar to 10% and similar to 20-30%, respectively and the measured levels of the uPAR forms were within the determined 95% reference intervals. No diurnal variation was found. Applying the normal upper limit of the reference intervals as cut-point for dichotomizing CRC patients revealed significantly decreased overall survival of patients with levels above this cut-point of any uPAR form. Conclusions: The reference intervals for the different uPAR forms are valid and the upper normal limits are clinically relevant cut-points for CRC prognosis. (C) 2014 Elsevier B.V. All rights reserved.
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