4.7 Article

Circulating intact and cleaved forms of the urokinase-type plasminogen activator receptor: Biological variation, reference intervals and clinical useful cut-points

期刊

CLINICA CHIMICA ACTA
卷 439, 期 -, 页码 84-90

出版社

ELSEVIER
DOI: 10.1016/j.cca.2014.10.004

关键词

Cancer biomarker; Urokinase receptor; Reference intervals; Age- and gender-dependent variation; Colorectal cancer; Time-resolved fluorescence immunoassay

资金

  1. Danish Cancer society [R40-A1771-11-S2]
  2. Axel Muusfeldt Foundation
  3. Copenhagen University Hospital [140382-XXXX/632-01]
  4. Lundbeck Foundation [R54-A5392]
  5. Aase and Ejnar Danielsen Fund
  6. Aage and Johanne Louis-Hansen Fund
  7. Walter and O. Kristiane Christensen Fund
  8. Sophus and Astrid Jacobsen Fund
  9. Arvid Nilsson Fund
  10. Glunz and Jensen Fund
  11. Friedrich and Else Boehm Fund
  12. Agnes and Poul Friis Fund
  13. Eva and Henry Fraenkel Fund
  14. Hartmann Bros. Fund
  15. Willy and Ingeborg Reinhard Fund
  16. Katrine and Vigo Skovgaard Fund
  17. Oda and Hans Svenningsen Fund
  18. Einar Willumsen Fund
  19. 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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