title: Intestinal mucosal MMP-1 - a prognostic factor in colon cancer.
abstract: OBJECTIVE
  There is evidence that transforming growth factor-β₁ (TGF-β₁) and matrix metalloproteinases (MMPs) play an important role in tumor invasion and progression in colorectal cancer. The aim of this study was to assess their utility in prediction of cancer-specific survival (CSS).
  
  
  METHODS
  136 patients undergoing curative surgery for colorectal carcinoma were prospectively included. Samples were taken from tumor and tumor-free intestinal mucosa and ELISA was used to assess protein levels in the tissues. Patients were followed for CSS. The median follow-up time for all included patients was 65 months (range: 45-92). The main outcome measure was CSS.
  
  
  RESULTS
  T stage, lymph node involvement and high levels of MMP-1 as well as MMP-9 in tumor-free mucosa tissue were significantly associated with CSS in colon cancer in univariate analysis. This prognostic strength was maintained for MMP-1 and N-status in multivariate analysis.
  
  
  CONCLUSIONS
  The results indicate that MMP-1 is independently associated with CSS in patients with colon cancer. Furthermore, a possible clinical implication is that MMP-1 protein expression in tumor-free mucosa could identify colon cancer patients with poor CSS in need of more intensified adjuvant treatment.
authors.affiliation: Department of Vascular Surgery, Sahlgrenska University Hospital, University of Gothenburg, Göteborg, Sweden. marcus.langenskiold@vgregion.se
authors.forename: Marcus
authors.initials: M
authors.lastname: Langenskiöld
authors.forename: Marie-Lois
authors.initials: ML
authors.lastname: Ivarsson
authors.forename: Lena
authors.initials: L
authors.lastname: Holmdahl
authors.forename: Peter
authors.initials: P
authors.lastname: Falk
authors.forename: Christina
authors.initials: C
authors.lastname: Kåbjörn-Gustafsson
authors.forename: Eva
authors.initials: E
authors.lastname: Angenete
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000201:enzymology* / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000201:enzymology*; D020781:Matrix Metalloproteinase 1 / Q000378:metabolism*; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D053773:Transforming Growth Factor beta1 / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D053773:Transforming Growth Factor beta1; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9; D020781:Matrix Metalloproteinase 1