DOI QR코드

DOI QR Code

Prognostic Value of MMP-9 in Ovarian Cancer: A Meta-analysis

  • Li, Li-Na ;
  • Zhou, Xin ;
  • Gu, Yang ;
  • Yan, Jun
  • Published : 2013.07.30

Abstract

Objective: Matrix metalloproteinase-9(MMP-9) plays an important role in tumor cell invasion. Although it has been studied frequently in ovarian cancer, its prognostic impact is still equivocal. The aim of this study was to more precisely estimate its prognostic significance. Method:We searched Pubmed, Embase, OVID, Sciencedirect and CBM databases to identify eligible studies. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (95% CIs) were pooled across studies using fixed-effects or random-effects models. We also performed subgroup analysis. Results: 30 studies (n=2552 patients) focusing on prognosis or expression of MM-9 were included. Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients (HR=1.68, 95%CI 1.09-2.59, p=0.02). Besides, MMP-9 expression in ovarian cancer was significantly higher than non-malignant tumors (OR=11.46, 95%CI 8.47-15.50, P<0.00001). Moreover, increased expression of MMP-9 was significantly associated with FIGO stage (OR=4.85, 95%CI 2.60-9.04, P<0.00001), grade of differentiation (OR=3.34, 95%CI 2.46-4.54, P<0.00001), lymph node metastasis (OR=5.75, 95%CI 3.71-8.92, P<0.00001) and there was no association with histological type of ovarian cancer. Conclusions: Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients. Down-regulation of MMP-9 is an attractive therapeutic approach which might improve outcome of ovarian cancer.

Keywords

MMP-9;prognosis;expression;ovarian cancer;meta-analysis

References

  1. Maatta M, Santalaa M, Soini Y, et al (2004). Matrix metalloproteinases 2 and 9 and their tissue inhibitors in low malignant potential ovarian tumors. Tumor Biol, 25, 188-92. https://doi.org/10.1159/000081101
  2. Murray GI, Duncan ME, Arbuckle E, et al (1998). Matrix metalloproteinases and their inhibitors in gastric cancer. Gut, 43, 791-7. https://doi.org/10.1136/gut.43.6.791
  3. Naylor MS, Stamp GW, Davies BD, et al (1994). Expression and activity of MMPs and their regulators in ovarian cancer. Int J Cancer, 58, 50-6. https://doi.org/10.1002/ijc.2910580110
  4. Oldenhuis CN, Oosting SF, Gietema JA, et al (2008). Prognostic vs predictive value of biomarkers in oncology. Eur J Cancer, 44, 946-53. https://doi.org/10.1016/j.ejca.2008.03.006
  5. Ozalp S, Tanir HM, Yalcin OT, et al (2003). Prognostic value of matrix metalloproteinase (gelatinase-B) expression in epithelial ovarian tumors. Eur J Gynaec Oncol, 5, 417-20.
  6. Parmar MK, Torri V, Stewart L (1998). Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med, 17, 2815-34. https://doi.org/10.1002/(SICI)1097-0258(19981230)17:24<2815::AID-SIM110>3.0.CO;2-8
  7. Qin M, Hu YQ (2011). VEGF and MMP-9 in ovarian cancer tissues and lymph node invasion and metastasis of transfer correlation. China Med Pharm, 1, 20-1.
  8. Remacle AG, Noel A, Duggan C, et al (1998). Assay of matrix metalloproteinases types 1, 2, 3 and 9 in breast cancer. Br J Cancer, 77, 926-31. https://doi.org/10.1038/bjc.1998.153
  9. Shen YF, Xu LL, Li FS, et al (2006). Expression of MMP-9,VEGF,Ki-67 in Krukenberg tumor,epithelial ovarian neoplasm. J Nanjing Med U, 26, 873.
  10. Siegel R, Naishadham D, Jemal A (2012). Cancer statistics. CA Cancer J Clin, 62, 10-29. https://doi.org/10.3322/caac.20138
  11. Sillanpaa S, Anttila M, Voutilainen K, et al (2007). Prognostic significance of matrix metalloproteinase-9 (MMP-9) in epithelial ovarian cancer. Gynecol Oncol, 104, 296-303. https://doi.org/10.1016/j.ygyno.2006.09.004
  12. Sood AK, Fletcher MS, Coffin JE, et al (2004). Functional role of matrix metalloproteinases in ovarian tumor cell plasticity. Am J Obstet Gynecol, 190, 899-909. https://doi.org/10.1016/j.ajog.2004.02.011
  13. Stallings-Mann M, Radisky D (2007). Matrix metalloproteinase-induced malignancy in mammary epithelial cells. Cells Tissues Organs, 185, 104-10. https://doi.org/10.1159/000101310
  14. Steels E, Paesmans M, Berghmans T, et al (2001). Role of p53 as a prognostic factor for survival in lung cancer: a systematic review of the literature with a meta-analysis. Eur Respir J, 18, 705-19. https://doi.org/10.1183/09031936.01.00062201
  15. Sugiura Y, Shimada H, Seeger RC, et al (1998). Matrix metalloproteinases-2 and -9 are expressed in human neuroblastoma: contribution of stromal cells to their production and correlation with metastasis. Cancer Res, 58, 2209-16.
  16. Sun SE, Tian LL, Yu HL (2008). Value of MMP-9 and PCNA expression in epithelial ovarian tumor. Matern Child Health Care Chi, 23, 975-7.
  17. Tian LL, Zhen JH, Zhang LZ (2007). Expression and significance of MMP 9 in epithelial ovarian cancer. J Qiqihar Med Coll, 28, 788-9.
  18. Wang FL, Lou YH, Yang XS, et al (2011). Expression of EGFR and MMP-9 in epithelial ovarian cancer and their correlation with prognosis of patients. Prog ObstetGynecol, 20, 689-92.
  19. Davidson B, Goldberg I, Gotlieb WH, et al (1999). High levels of MMP-2, MMP-9, MT1-MMP and TIMP-2 mRNA correlate with poor survival in ovarian carcinoma. Clin Exp Metastasis, 17, 799-808. https://doi.org/10.1023/A:1006723011835
  20. Davidson B, Goldberg I, Kopolovic J, et al (1999). Expression of matrix metalloproteinase-9 in squamous cell carcinoma of the uterine cervix-clinicopathologic study using immunohistochemistry and mRNA in situ hybridization. Gynecol Oncol, 72, 380-6. https://doi.org/10.1006/gyno.1998.5285
  21. Guo BQ, Yu L, Wu SW, et al (2011). Expression of HE4, NF-${\kappa}b$ p65, MMP-9 and Their Clinical Significance in Epithelial Ovarian Noeplasm. Chinese J Histochem Cytochem, 20, 578-83.
  22. Himelstein BP, Canete-Soler R, Berhnhard EJ, et al (1994-1995). Metalloproteinases in tumor progression: the contribution of MMP-9. Invas Metast, 14, 246-58.
  23. Huang LW, Garrett AP, Bell DA, et al (2000). Differential expression of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 protein and mRNA in epithelial ovarian tumors. Gynecol Oncol, 77, 369-76. https://doi.org/10.1006/gyno.2000.5806
  24. Hu J (2011). Expression of MMP2 and MMP9 in tissue of epithelial tumor of ovary and its clinical significance. Chin Med Mod Dis China, 9, 208-10.
  25. Hu XX, Li DR, Zhang W, et al (2012). Matrix metalloproteinase-9 expression correlates with prognosis and involved in ovarian cancer cell invasion. Arch Gynecol Obstet, 286, 1537-43. https://doi.org/10.1007/s00404-012-2456-6
  26. Jean LB, Cortez A, Lesieur B, et al (2012). Expression of MMP-2,-7,-9, MT1-MMP and TIMP-1 and -2 has no prognostic relevance in patients with advanced epithelial ovarian cancer. Oncol Rep, 27, 1049-57.
  27. Kamat AA, Fletcher M, Gruman LM, et al (2006).The clinical relevance of stromal matrix metalloproteinase expression in ovarian cancer. Clin Cancer Res, 12, 1707-14. https://doi.org/10.1158/1078-0432.CCR-05-2338
  28. Kessenbrock K, Plaks V, Werb Z (2010). Matrix metalloproteinases: regulators of the tumor microenvironment. Cell, 141, 52-67. https://doi.org/10.1016/j.cell.2010.03.015
  29. Lampert K, Machein U, Machein MR, et al (1998). Expression of matrix metalloproteinases and their inhibitors in human brain tumors. Am J Pathol, 153, 429-37. https://doi.org/10.1016/S0002-9440(10)65586-1
  30. Landis SH, Murray T, Bolden S, et al (1999). Cancer statistics. CA Cancer J Clin, 49, 8-31. https://doi.org/10.3322/canjclin.49.1.8
  31. Lengyel E, Schmalfeldt B, Konik E, et al (2001). Expression of latent matrix metalloproteinase 9 (MMP-9) predicts survival in advanced ovarian cancer. Gynecol Oncol, 82, 291C8.
  32. Li DC, Liang LZ, Deng GP (2008). The clinical significance of mmp-9 Protein expression in epithelial ovarian carcinoma. Prac J Cancer, 23, 001-2.
  33. Li JQ, Shi YF, Zhou HJ, et al (2003) . Express ions of MMP-9 and TIMP-1 in epithelial ovarian neoplasms. Prog Obstet Gynecol, 12, 1703.
  34. Lou G, Gao Y, Ning XM, et al (2005). Expression and correlation of CD44v6, vascular endothelial growth factor, matrix metalloproteinase-2, and matrix metalloproteinase-9 in Krukenberg tumor. World J Gastroenterol, 11, 5032-6.
  35. Alshenawy HA (2010). Immunohistochemical expression of epidermal growth factor receptor, E-cadherin, and matrix metalloproteinase-9 in ovarian epithelialcancer and relation to patient deaths. Ann Diagn Pathol, 14, 387-95. https://doi.org/10.1016/j.anndiagpath.2010.05.005
  36. Aznavoorian S, Murphy AN, Stetler-Stevenson WG, et al (1993). Molecular aspects of tumor cell invasion and metastasis. Cancer, 71, 1368-83. https://doi.org/10.1002/1097-0142(19930215)71:4<1368::AID-CNCR2820710432>3.0.CO;2-L
  37. Berman ML (2003). Future directions in the surgical management of ovarian cancer. Gynecol Oncol, 90, S33-9. https://doi.org/10.1016/S0090-8258(03)00342-1
  38. Clark T, Stewart M, Altman D, et al (2001).A prognostic model for ovarian cancer. Br J Cancer, 85, 944. https://doi.org/10.1054/bjoc.2001.2030
  39. Wang XM, Sun L, Zhen RS, et al (2005). Expression and Clinical Significance of MMP -9 and TIMP -1 in Epithelial Ovarian Tumor Using Tissue Microarray Technique. Cancer Res on Pre and Treat, 32, 484-6.
  40. Wang XY,Zhang YK,Ren GC (2004). Relation between expression of MMP-2 and MMP-9 and invasion,metastasis of epithelial carcinoma of ovary. Chin J Clin Oncol Rehabil, 11, 406-8.
  41. Wu JX, Zhao Y, Jia SJ, et al (2007). Expressions of MMP-2, MMP-3, MMP-9 and CD147 in human ovarian cancer and their clinicopathological s ignificance. J Chongqing Med U, 32, 1165-8.
  42. Xing LY , Cai DG, Fang XH, et al (2007). Study of expression and correlation of cathepsin B and matrix metallo-proteinase-9 in epithelial ovarian tumor. J Xi'an Jiaotong U, 28, 582-4.
  43. Yan H, Tan WH (2008). Expression of VEGF and MMP-9 in the epithelial ovavian cavcinoma and its significance. Hei Long Jiang Med J, 32, 89-92.
  44. Yusuf S, Peto R, Lewis J, et al (1985). Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis, 27, 335-71. https://doi.org/10.1016/S0033-0620(85)80003-7
  45. Zeng XL, Peng YJ (2010). Expression and clinical significance of VEGF, MMP-2 and MMP-9 invovarian carcinoma. Prog Mod Bio, 10, 2322-4.
  46. Zeng ZS, Cohen AM, Guillem JG (1999). Loss of basement membrane type IV collagen is associated with increased expression of metalloproteinase 2 and 9 (MMP-2 ad MMP-9) during human colorectal tumorigenesis. Carcinogenesis, 20, 749-55. https://doi.org/10.1093/carcin/20.5.749
  47. Zhang DN, Zhang QH, Li HM (2011). Expression and significance of MMP 9 and VEGF in ovarian cancer. Chin J Lab Diagn, 15, 1384-95.
  48. Zhang HJ, Wu XH, Ruo R (2006). Study on the expressions of vascular endothelial growth factor and its receptors and matrix metalloproteinase 9 in epithelial ovarian cancer. Tianjin Med J, 34, 165-7.
  49. Zhang LJ,Tan WH,Yang QH (2007). Expression and significance of MMP 9 and laminin receptor in epithelial ovarian neoplasm. Chin J Birth Health Hered, 15, 31-2.

Cited by

  1. Expression of High Mobility Group Box - B1 (HMGB-1) and Matrix Metalloproteinase-9 (MMP-9) in Non-small Cell Lung Cancer (NSCLC) vol.15, pp.12, 2014, https://doi.org/10.7314/APJCP.2014.15.12.4865
  2. Impact of Prognostic Factors on Survival Rates in Patients with Ovarian Carcinoma vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6087
  3. Cinobufacin Suppresses Cell Proliferation via miR-494 in BGC-823 Gastric Cancer Cells vol.15, pp.3, 2014, https://doi.org/10.7314/APJCP.2014.15.3.1241
  4. Decreased expression of carbonyl reductase 1 promotes ovarian cancer growth and proliferation vol.46, pp.3, 2014, https://doi.org/10.3892/ijo.2014.2810
  5. Inhibition of Metastasis and Invasion of Ovarian Cancer Cells by Crude Polysaccharides from Rosa Roxburghii Tratt in Vitro vol.15, pp.23, 2015, https://doi.org/10.7314/APJCP.2014.15.23.10351
  6. Ovarian cancer: involvement of the matrix metalloproteinases vol.150, pp.2, 2015, https://doi.org/10.1530/REP-14-0546
  7. MMP2 Gene-735 C/T and MMP9 gene -1562 C/T Polymorphisms in JAK2V617F Positive Myeloproliferative Disorders vol.16, pp.2, 2015, https://doi.org/10.7314/APJCP.2015.16.2.443
  8. Microvessel Density as a Prognostic Factor in Ovarian Cancer: a Systematic Review and Meta-analysis vol.16, pp.3, 2015, https://doi.org/10.7314/APJCP.2015.16.3.869
  9. Nitidine chloride inhibits ovarian cancer cell migration and invasion by suppressing MMP-2/9 production via the ERK signaling pathway vol.13, pp.4, 2016, https://doi.org/10.3892/mmr.2016.4929
  10. Relationship between matrix metalloproteinases and the occurrence and development of ovarian cancer vol.50, pp.6, 2017, https://doi.org/10.1590/1414-431x20176104
  11. Matrix Metalloproteinase-9 (MMP-9) as a Cancer Biomarker and MMP-9 Biosensors: Recent Advances vol.18, pp.10, 2018, https://doi.org/10.3390/s18103249

Acknowledgement

Supported by : National Science Foundation of China