title: Metaanalysis of the significance of matrix metalloproteinases for lymph node disease in patients with head and neck squamous cell carcinoma.
abstract: BACKGROUND
  The objective of the current metaanalysis was to evaluate the expression patterns of matrix metalloproteinases (MMPs) in patients with head and neck squamous cell carcinoma (HNSCC), to evaluate reported series, and to determine whether there is an expressed value to quantitate the risk of metastasis.
  
  
  METHODS
  A review of the published literature was conducted according to defined selection criteria. Fixed and random effects models were applied for estimation of the summarized odds ratio and 95% confidence intervals, including a test for homogeneity of the odds ratios of the studies. Finally, forest plots were created to allow for visual comparison of the results and an estimation of heterogeneity.
  
  
  RESULTS
  The heterogeneity of data collection and statistical methods did not allow final judgments on the significance of immunohistochemical MMP expression analysis in patients with HNSCC or the impact of MMPs in predicting metastatic behavior. Fourteen studies with 710 patients for 5 different MMPs (MMP-1, MMP-2, MMP-3, MMP-9, and MMP-14) were included in the current metaanalysis. The results indicated that MMP-2, MMP-3, MMP-14 possibly played a role in the metastatic behavior of HNSCC tumors.
  
  
  CONCLUSIONS
  The authors recommended the standardization of staining procedures and evaluation protocols as a necessary step to allow for valid comparisons of the multitude of results published by different study groups.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipps-University of Marburg, Marburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Wiegand
authors.forename: Anja A
authors.initials: AA
authors.lastname: Dünne
authors.forename: Helge H
authors.initials: HH
authors.lastname: Müller
authors.forename: Robert
authors.initials: R
authors.lastname: Mandic
authors.forename: Peter
authors.initials: P
authors.lastname: Barth
authors.forename: Ronald K
authors.initials: RK
authors.lastname: Davis
authors.forename: Jochen A
authors.initials: JA
authors.lastname: Werner
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000201:enzymology* / Q000473:pathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000201:enzymology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D020781:Matrix Metalloproteinase 1 / Q000378:metabolism; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D019278:Matrix Metalloproteinase 3 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D053504:Matrix Metalloproteinases, Membrane-Associated; D008666:Metalloendopeptidases / Q000378:metabolism; D012307:Risk Factors
chemical_list: D020782:Matrix Metalloproteinases; D053504:Matrix Metalloproteinases, Membrane-Associated; D008666:Metalloendopeptidases; D019278:Matrix Metalloproteinase 3; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9; D020781:Matrix Metalloproteinase 1