title: Expression of matrix metalloproteinases in patients with uterine smooth muscle tumors: an immunohistochemical analysis of MMP-1 and MMP-2 protein expression in leiomyoma, uterine smooth muscle tumor of uncertain malignant potential, and leiomyosarcoma.
abstract: OBJECTIVE
  Matrix metalloproteinases (MMPs) have been suggested to play an important role in tumor invasion and metastasis. We compared the expression of MMP-1 and MMP-2 protein in patients with leiomyoma, uterine smooth muscle tumor of uncertain malignant potential (STUMP), and leiomyosarcoma (LMS).
  
  
  METHODS
  MMP-1 and MMP-2 expression was investigated by immunohistochemistry from paraffin-embedded tissue in 26 patients with leiomyoma, in 24 patients with STUMP, and in 21 patients with LMS.
  
  
  RESULTS
  MMP-1 was expressed in 92% of leiomyomas, in 83% of STUMP, and in 86% of LMS, whereas MMP-2 was expressed in 12% of leiomyomas, in 17% of STUMP, and in 48% of LMS. A statistically significant difference regarding the frequency of MMP-2 expression was observed between LMS and STUMP (P =.025) as well as between LMS and leiomyoma (P =.006), but not between STUMP and leiomyoma (P >.05). Likewise, the staining intensity did significantly differ between LMS and leiomyoma (P =.025), but no statistical significant difference was observed between LMS and STUMP (P >.05) and between STUMP and leiomyoma (P >.05).
  
  
  CONCLUSIONS
  The stronger MMP-2 expression in patients with LMS compared with STUMP and leiomyoma indicates that this protein might be a marker for tumor invasion or metastasis in patients with uterine LMS. Furthermore, MMP-2 seems to be a useful immunohistochemical parameter to distinguish cases of smooth muscle tumors in which histologic features are ambiguous or borderline. Further studies including larger numbers of patients are necessary to establish MMP-2 as a routine marker for tumor invasion and progression.
authors.affiliation: Department of Gynecology and Obstetrics, University of Vienna Medical School, Vienna, Austria. klausbodner@yahoo.com
authors.forename: B
authors.initials: B
authors.lastname: Bodner-Adler
authors.forename: K
authors.initials: K
authors.lastname: Bodner
authors.forename: O
authors.initials: O
authors.lastname: Kimberger
authors.forename: K
authors.initials: K
authors.lastname: Czerwenka
authors.forename: S
authors.initials: S
authors.lastname: Leodolter
authors.forename: K
authors.initials: K
authors.lastname: Mayerhofer
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000201:enzymology*; D007890:Leiomyosarcoma / Q000201:enzymology*; D020781:Matrix Metalloproteinase 1 / Q000032:analysis*; D020778:Matrix Metalloproteinase 2 / Q000032:analysis*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D018235:Smooth Muscle Tumor / Q000201:enzymology*; D015996:Survival Rate; D014594:Uterine Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology
chemical_list: D020778:Matrix Metalloproteinase 2; D020781:Matrix Metalloproteinase 1