title: Prognostic role of MMP-9 expression in head and neck carcinoma patients treated with radiotherapy or chemoradiotherapy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the prognostic significance of the expression of metalloproteinases (MMPs)-2 and -9 at a transcriptional level in patients with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Real-time polymerase chain reaction was used to determine mRNA expression levels of MMP-2 and MMP-9 in 105 consecutive patients with HNSCC treated with radiotherapy or chemoradiotherapy. Continuous values of mRNA expression levels were analyzed using a classification and regression tree (CART) method.
  
  
  RESULTS
  Patients were grouped into two categories according to the results from CART analysis; high (n=71) and low (n=34) expression levels of MMP-9. MMP-2 expression was not included in the model. The 5-year adjusted survival rate was 92.9% for patients with low MMP-9 expression level and 61.0% for patients with a high expression level (P=0.006). Overexpression of MMP-9 was associated with a decrease in local control of the disease. In a multivariate analysis, MMP-9 expression was the only variable that was associated with adjusted survival. Considering patients with a low MMP-9 expression level as the reference group, patients with a high MMP-9 expression level had a 6.1 times higher risk of death from HNSCC (CI 95%: 1.4-26.4).
  
  
  CONCLUSIONS
  We found a significant relationship between the transcription of MMP-9 and adjusted survival in HNSCC patients treated with radiotherapy or chemoradiotherapy. These results suggest that MMP-9 transcription may serve as a marker of treatment response to radiotherapy or chemo-radiotherapy in patients with HNSCC.
authors.affiliation: Otorhinolaryngology Department, Hospital Moisés Brogi, Hospitalet, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Virós
authors.forename: Mercedes
authors.initials: M
authors.lastname: Camacho
authors.forename: Iñaki
authors.initials: I
authors.lastname: Zarraonandia
authors.forename: Jacinto
authors.initials: J
authors.lastname: García
authors.forename: Miquel
authors.initials: M
authors.lastname: Quer
authors.forename: Luis
authors.initials: L
authors.lastname: Vila
authors.forename: Xavier
authors.initials: X
authors.lastname: León
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000201:enzymology* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000201:enzymology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000235:genetics / Q000378:metabolism*; D008875:Middle Aged; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D020780:Matrix Metalloproteinase 9