Summary Plasminogen activator (PA) is a serine protease existing in two forms known as tissue-type (t-PA) and urokinase-type (u-PA). To examine whether PA is related to the postoperative clinical course of human breast cancer, total PA activity, t-PA activity, u-PA activity, and immunoreactive t-PA were determined in tissue extracts from 144 breast cancer specimens. The patients were initially divided into four groups according to the postoperative clinical course: Group I (83 patients who are disease-free), Group II (20 patients whose first metastases were found only in bone), Group III (19 patients whose first metastases were found in both bone and lung), and Group IV (22 patients whose first metastases were found only in lung). Total PA activity was significantly lower in Groups, II, III and IV than in Group I. Both t-PA activity and t-PA antigen levels were also significantly lower in Groups II, III and IV than in Group I, while no significant difference was found in u-PA activity among these groups, indicating that low activity of total PA in Groups II, III and IV was due to a decrease in t-PA but not in u-PA. In the multivariate analyses, t-PA activity was found to be an independent prognostic factor for relapse-free survival. When four groups of patients were further analysed in terms of nodal status, both t-PA activity and antigen levels were markedly decreased in the node-negative Group II compared with the node-negative Groups III and IV or with the node-positive Groups II, III and IV. Of additional interest, u-PA activity was significantly higher in node-positive patients than in nodenegative patients with any group. The clinico-pathologic analyses of the patients in this series showed that node involvement and lymphatic invasion were more frequently positive in Groups III and IV than in Groups I and II. When 144 breast cancers were categorised in terms of combinations of oestrogen receptor (ER) and progesterone receptor (PgR) status, breast cancers which were positive for both receptors were found to contain the highest t-PA activity and antigen. This study provides provocative evidence suggesting a possible differential significance of t-PA and u-PA expression in human breast cancer.Many transformed or malignant tumour cells are known to produce plasminogen activator (PA), a serine-type protease converting plasminogen to plasmin (Unkeless et al., 1975;Howett et al., 1978;Orenstein et al., 1983). It is widely accepted that PA is intimately involved in the metastatic spread of tumour cells (Dano et al., 1985;Colombi et al., 1986;Mignatti et al., 1986;Reich et al., 1988;Ossowski et al., 1988;Markus et al., 1988;Yu et al., 1990;Testa et al., 1990;Hollas et al., 1991). There are two main forms of PA: urokinase type (u-PA) and tissue-type (t-PA). While both catalyse cleavage of the peptide bond between Arg-Val in plasminogen, thus converting the proenzyme to plasmin, they differ in many aspects such as their molecular weight, immunological reactivity and amino acid sequence (Ny et al., 1984;Riccio et al.,...