Expression of matrix metalloproteinases in supraglottic carcinoma and its clinical implication for estimating lymph node metastases.
OBJECTIVE
Twenty to 30% of clinically node-negative patients with squamous cell carcinoma (SCC) of supraglottic larynx were pathologically confirmed with occult lymph node metastasis after operation. Therefore, preoperative judgment on the neck node metastasis should be very important for making an appropriate surgical plan. The purpose of this study is to explore the role of matrix metalloprotineases (MMPs) in the metastatic potential of supraglottic carcinoma in this regard.


METHODS
Examination of MMPs expression in supraglottic carcinoma and establishment of the mathematic model for diagnosis of occult lymph node metastases in a prospective manner.


METHODS
Thirty-two patients with supraglottic SCC underwent supraglottic horizontal partial laryngectomy and neck dissection, and the samples of primary cancer and the corresponding adjacent non-neoplastic tissues were evaluated for both mRNA and protein expression of MMP-1, MMP-2, MMP-7, MMP-8, MMP-9, and MMP-10 using reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry. In addition, cervical lymph nodes were examined by routine histopathology to determine whether there was any evidences of node metastasis. RT-PCR and immunohistochemical data were analyzed by multivariate logistic regression, and then two mathematical models were established according to the multivariate logistic regression analysis.


RESULTS
Among the six kinds of MMPs, both mRNA and protein expression of MMP-2, MMP-7, and MMP-9 were found up-regulated in more than 63% of the tumor tissues as compared with the adjacent non-neoplastic tissues, and this was significantly correlated with lymph node metastasis (all P < .05). Twenty patients, including seven cases with N0, were pathologically confirmed as having cervical lymph node metastasis. Using RT-PCR and immunohistochemical data of MMP-2, MMP-7, and MMP-9, two mathematic models were tested, and their diagnostic efficiencies for lymph node metastasis were 84% and 88%, respectively.


CONCLUSIONS
Expressions of MMP-2, MMP-7, and MMP-9 are up-regulated in supraglottic carcinoma tissues, suggesting that MMPs may be useful in the detection of occult lymph node metastasis but that more research is needed.
Xie
Minqiang
M
From the Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat Sen University, Guangzhou 510-630, P.R. China. xiemqgz@public.guangzhou.gd.cn
Sun
Yanan
Y
Li
Yun
Y
D000328:Adult; D000368:Aged; D001483:Base Sequence; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D008875:Middle Aged; D008969:Molecular Sequence Data; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D020782:Matrix Metalloproteinases