Prognostic impact of serum and tissue MMP-9 in non-small cell lung cancer: a systematic review and meta-analysis
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Liang Gong1,*, Dan Wu2,*, Jianding Zou1, Jianqiang Chen1, Liangyu Chen1, Yun Chen3, Chao Ni4, Hongjun Yuan4
1Department of Otorhinolaryngology, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi 315300, China
2Department of Thoracic surgery, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi 315300, China
3Department of Oncology, Zhejiang Provincial People’s Hospital, Hangzhou 310004, China
4Department of General Surgery, Zhejiang Provincial People’s Hospital, Hangzhou 310004, China
Hongjun Yuan, e-mail: email@example.com
Chao Ni, e-mail: firstname.lastname@example.org
Keywords: matrix metalloprotease-9, non-small cell lung cancer, immunohistochemistry, ELISA
Received: December 07, 2015 Accepted: February 14, 2016 Published: February 23, 2016
Matrix metalloproteinases-9 (MMP-9) was one of the most important enzyme to breakdown extracellular matrix, aim to clarify the prognostic value of MMP-9 in non-small cell lung cancer (NSCLC), we investigated the serum MMP-9 of NSCLC patients and performed a meta-analysis of the published literature. The expression and activity of serum MMP-9 were assessed by ELISA and gelatin zymography in 163 NSCLC patients. Moreover, 26 studies were included in meta-analysis by searching Medline and ISI Web of Knowledge. Our own data revealed high activity but not expression of MMP-9 significantly correlated with advanced T category and positive metastasis. In contrast, the meta-analysis revealed that increased MMP-9 level indicate high T category (RR = 0.83, 95% CI: 0.73-0.94), tumor stage (RR = 0.72, 95% CI: 0.63-0.82) and poor OS (5-year overall survival, RR = 1.32, 95% CI: 1.19-1.48). Moreover, stratified analysis based on sample types found that high MMP-9 expression in tissue specimen but not serum was significant correlated with advanced T category (RR = 0.81, 95% CI: 0.72-0.92), tumor stage (RR = 0.69, 95% CI: 0.60-0.80) and poor 5-year OS (1.33, 95% CI: 1.18-1.50).In conclusion, the activity of MMP-9 was positively correlated with advanced T category and distant metastasis. Moreover, the meta-analysis revealed that overexpression of MMP-9 in tissue but not in serum was a risk factor of advanced T category, tumor stage and poor outcome.
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