الفهرس 
Incidence and epidemiologyOnly 14 pages are availabe for public view
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Abstract
The urokinase-type plasminogen activator is a specific serine protease, which converts plasminogen into its active form, plasmin, a broad-spectrum serine protease involved in the digestion of basement membranes and of various protein substrates in the extracellular matrix. Therefore, it plays a crucial role in tumor progression.
The aim of the present study was to estimate the plasma level of circulating suPAR and to determine its prognostic relevance in AML patients. It was performed on 43 newly diagnosed AML patients attending the Hematology Oncology Clinic of Ain Shams University Hospital and 20 healthy volunteers matching in age and sex in the year 2017.
The patients age ranged from 19 to 73 years old, with mean age of 45 ± 16.24 years. Twenty two out of 43 (51.2 %) of the patient group were males and 21/43 (48.8 %) were females, the control group age ranged from 20 to 64 years old, with mean age of 38.5 ± 13.50 years. Nine out of 20 (45%) were males and 11/20 (55%) were females.
All the patients were subjected to full history taking, full clinical examination and routine laboratory investigations. Bone marrow examination, with morphological assessment of bone marrow blast cell percentage, routine immunophenotyping and conventional cytogenetic analysis were done (for study group only). Enzyme-linked immunosorbent assay (ELISA) for suPAR was performed on plasma samples collected from both groups using Quantikine® ELISA Human uPAR Immunoassay kit.
The results revealed that the value of suPAR was higher among the patients group compared to the control group and this difference was statistically highly significant.
It showed no statistical difference between level of suPAR and gender or age.
Regarding the clinical data, there was a significant relationship between suPAR level and both hepatomegaly and splenomegaly.
Regarding laboratory data, our study reported, a significant correlation between suPAR level and TLC and platelets, however there is no significant correlation between suPAR and Hb level, peripheral blood blasts and bone marrow blasts infiltration.
Another finding was the lack of association between circulating suPAR level and different FAB subtypes.
Regarding cytogenetic analysis, no significant association was found between circulating suPAR level and cytogenetic abnormalities.Moreover, our results demonstrated a strong correlation between circulating level of suPAR and therapeutic outcome in treated AML patients with induction treatment. Patients with high plasma level of suPAR displayed a significantly worse outcome than those with lower level and this difference was statistically highly significant.
The best cutoff value for suPAR level to discriminate between patients and control was found to be more than 2500 pg/ml with sensitivity = 81.4 % and specificity = 75 %.
The best cut off value for suPAR in predicting those patients with poor prognosis was found to be more than 4250 pg/ml with sensitivity = 83.3 % and specificity= 92.3 %.