The role of PAI-1 in cancer cell adhesion also remains controversial, with some studies demonstrating that overexpression of PAI-1 upregulates cell surface expression of integrins thereby enhancing tumor cell adhesive properties [43], and others showing that PAI-1-induced LRP-1 mediated endocytosis impairs tumor cell binding to ECM [44]. Here, SERPINE1 is linked to neoplasm.