title: Tissue and serum metalloproteinase (MMP-2) expression in advanced ovarian serous cystoadenocarcinomas: clinical and prognostic implications.
abstract: OBJECTIVE
  The object of this study was to analyse the tissue and serum metalloproteinase (MMP-2), an enzyme which degrades the basement membrane collagen type IV, as a potential marker useful in prognostic evaluation and clinical monitoring of the follow-up, in patients with advanced ovarian serous cystadenocarcinoma.
  
  
  METHODS
  Tissue MMP-2 expression was determined in 21 FIGO stage III ovarian serous cystadenocarcinomas treated with primary surgery and adjuvant chemotherapy, and compared to 10 cystadenomas used as controls. Retrospective analysis of clinical data allowed the comparison of accepted prognostic factors to tissue MMP-2 expression for impact on disease-free survival. In fourteen out of 21 patients, serum MMP-2 levels were also analysed.
  
  
  RESULTS
  Compared to cystadenomas, the tissue MMP-2 expression was significantly (P < 0.001) higher in serous cystadenocarcinomas. A significant relationship was observed between tissue MMP-2 and disease-free survival (P = 0.0003), independently of tumor architectural grade, lymph nodal status and residual disease after debulking surgery. Recurrence risk in patients whose carcinomas had a tissue MMP-2 > or = 29% was significantly higher than that in patients whose carcinomas demonstrated lower tissue MMP-2 expression (P = 0.004). Serum MMP-2 levels correlated with tissue staining, and also expressed a significant relationship with disease-free survival (P = 0.002).
  
  
  CONCLUSIONS
  Tissue MMP-2 seems to be a prognostic indicator in patients with FIGO stage III ovarian serous cystadenocarcinoma, significantly correlated with recurrence risk and apparently independent of tumor architectural grade, lymph nodal status, and residual disease after debulking surgery. An interesting relationship was observed between tissue staining and MMP-2 serum levels.
authors.affiliation: Institute of Gynecology and Obstetrics, Ancona University, Italy.
authors.forename: G G
authors.initials: GG
authors.lastname: Garzetti
authors.forename: A
authors.initials: A
authors.lastname: Ciavattini
authors.forename: G
authors.initials: G
authors.lastname: Lucarini
authors.forename: G
authors.initials: G
authors.lastname: Goteri
authors.forename: M
authors.initials: M
authors.lastname: de e Nictolis
authors.forename: S
authors.initials: S
authors.lastname: Garbisa
authors.forename: L
authors.initials: L
authors.lastname: Masiero
authors.forename: C
authors.initials: C
authors.lastname: Romanini
authors.forename: B
authors.initials: B
authors.lastname: Graziella
mesh_terms: D001485:Basement Membrane / Q000378:metabolism; D003094:Collagen / Q000378:metabolism; D018284:Cystadenocarcinoma, Serous / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D003537:Cystadenoma / Q000201:enzymology; D018572:Disease-Free Survival; D005260:Female; D018093:Gelatinases / Q000032:analysis*; D006801:Humans; D007124:Immunoenzyme Techniques; D020778:Matrix Metalloproteinase 2; D008666:Metalloendopeptidases / Q000032:analysis*; D009361:Neoplasm Invasiveness; D009363:Neoplasm Proteins / Q000032:analysis*; D010051:Ovarian Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D009363:Neoplasm Proteins; D003094:Collagen; D018093:Gelatinases; D008666:Metalloendopeptidases; D020778:Matrix Metalloproteinase 2