This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leppä, S. Articles by Elomaa, I. Search for Related Content PubMed PubMed Citation Articles by Leppä, S. Articles by Elomaa, I.

A High Serum Matrix Metalloproteinase-2 Level Is Associated with an Adverse Prognosis in Node-Positive Breast Carcinoma

¹ Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland; ² Molecular Cancer Biology Research Program, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland; and ³ Department of Oncology, University of Uppsala, Uppsala, Sweden

Purpose: The aim of this study was to determine whether serum matrix metalloproteinase (MMP) -2 and MMP-9 levels could predict overall and disease-free survival in primary node-positive breast cancer.

Experimental Design: MMP-2 and MMP-9 levels were quantitatively measured in serum after surgery from 133 patients with primary node-positive breast cancer using enzyme-linked immunoassays. All of the patients received adjuvant therapy, postmenopausal endocrine treatment (tamoxifen or toremifen for 3 years) and premenopausal six cycles of CMF chemotherapy. The follow-up time for all of the patients was 5 years.

Results: Overall survival (OS) and disease-free survival (DFS) rates were better among patients with low MMP-2 levels than in patients with high levels (OS, 91% versus 75%, P = 0.020; DFS, 82% versus 58%, P = 0.005). The appearance of bone and visceral metastases was also significantly lower in patients with low serum MMP-2 levels (bone metastases, 10% versus 23%, P = 0.050; visceral metastases, 12% versus 34%, P = 0.018). The prognostic value of MMP-2 levels was most pronounced among a subgroup of estrogen receptor-positive patients (OS, 96% versus 78%, P = 0.052; DFS, 85% versus 58%, P = 0.014), whereas no significant difference was found among estrogen receptor-negative patients (OS, 73% versus 69%, P = 0.25; DFS, 73% versus 63%, P = 0.32). In multivariate analysis, MMP-2 level together with nodal status (NS), progesterone receptor (PgR), and tumor size (T) remained independent predictors for DFS (NS, P = 0.002; PgR, P = 0.004; T, P = 0.023; MMP2, P = 0.039) and OS (NS, P = 0.0002; PgR, P = 0.004; T, P = 0.004; MMP2, P = 0.032). MMP-9 levels did not correlate with survival.

Conclusions: The results suggest that serum postoperative MMP-2 level is a predictor of DFS and OS, and could help to stratify breast cancer patients with primary node-positive disease into low- and high-risk groups.

This article has been cited by other articles:

				S.-F. Yang, P.-H. Wang, L.-Y. Lin, J.-L. Ko, G.-D. Chen, J.-S. Yang, H.-S. Lee, and Y.-S. Hsieh A Significant Elevation of Plasma Level of Matrix Metalloproteinase 9 in Patients With High-Grade Intraepithelial Neoplasia and Early Squamous Cell Carcinoma of the Uterine Cervix Reproductive Sciences, October 1, 2007; 14(7): 710 - 718. [Abstract] [PDF]

				S O Wurtz, A-S Schrohl, N M. Sorensen, U Lademann, I J Christensen, H Mouridsen, and N Brunner Tissue inhibitor of metalloproteinases-1 in breast cancer Endocr. Relat. Cancer, June 1, 2005; 12(2): 215 - 227. [Abstract] [Full Text] [PDF]

				H. Ruokolainen, P. Paakko, and T. Turpeenniemi-Hujanen Tissue Inhibitor of Matrix Metalloproteinase-1 Is Prognostic in Head and Neck Squamous Cell Carcinoma: Comparison of the Circulating and Tissue Immunoreactive Protein Clin. Cancer Res., May 1, 2005; 11(9): 3257 - 3264. [Abstract] [Full Text] [PDF]

				S. O. Wurtz, I. J. Christensen, A.-S. Schrohl, H. Mouridsen, U. Lademann, V. Jensen, and N. Brunner Measurement of the Uncomplexed Fraction of Tissue Inhibitor of Metalloproteinases-1 in the Prognostic Evaluation of Primary Breast Cancer Patients Mol. Cell. Proteomics, April 1, 2005; 4(4): 483 - 491. [Abstract] [Full Text] [PDF]