A high serum matrix metalloproteinase-2 level is associated with an adverse prognosis in node-positive breast carcinoma
A high serum matrix metalloproteinase-2 level is associated with an adverse prognosis in node-positive breast carcinoma
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DOI：
10.1158/1078-0432.ccr-03-0047
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发表时间：
2004-02-01
影响因子：
11.5
通讯作者：
Elomaa, I
中科院分区：
文献类型：
--
作者：
Leppä, S;Saarto, T;Elomaa, I
目的：本研究的目的是确定是否血清基质金属蛋白酶（MMP）-2和MMP-9水平可以预测总体和无病生存在原发性淋巴结阳性breast cancer.Experimental Design：MMP-2和MMP-9水平进行定量测定，从133例原发性淋巴结阳性乳腺癌患者手术后血清中使用酶联免疫测定。所有患者均接受辅助治疗、绝经后内分泌治疗（三苯氧胺或托瑞米芬治疗3年）和绝经前CMF化疗6个周期。结果：低MMP-2水平患者的总生存率（OS）和无病生存率（DFS）均高于高MMP-2水平患者（OS，91%vs75%，P = 0.020; DFS，82%vs58%，P = 0.005）。在血清MMP-2水平低的患者中，骨和内脏转移的出现也显著较低（骨转移，10%比23%，P = 0.050;内脏转移，12%比34%，P = 0.018）。MMP-2水平的预后价值在雌激素受体阳性患者的亚组中最为显著（OS，96%比78%，P = 0.052; DFS，85%比58%，P = 0.014），而雌激素受体阴性患者之间无显著差异（OS，73%对69%，P = 0.25; DFS，73%对63%，P = 0.32）。在多变量分析中，MMP-2水平与淋巴结状态（NS）、孕激素受体（PgR）和肿瘤大小（T）一起仍然是DFS的独立预测因子（NS，P = 0.002; PgR，P = 0.004; T，P = 0.023; MMP 2，P = 0.039）和OS（NS，P = 0.0002; PgR，P = 0.004; T，P = 0.004; MMP 2，P = 0.032）。MMP-9水平与survival.Conclusions：结果表明，血清术后MMP-2水平是DFS和OS的预测因子，可以帮助将原发淋巴结阳性的乳腺癌患者分为低风险组和高风险组。
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.