title: The Clinical Utility of Matrix Metalloproteinase 9 in Evaluating Pathological Grade and Prognosis of Glioma Patients: A Meta-Analysis.
abstract: In the recent years, matrix metalloproteinase 9 (MMP-9) has been focused on as an indicator of glioma grade and prognosis, especially in China. However, all results resulted in many conflicts. So, it is necessary to conduct a meta-analysis to secure a convincing correlation between MMP-9 and grade and prognosis. Eligible studies were included via multiple searches, and then odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were estimated. Funnel plots were available for evaluation of publication bias. In addition, heterogeneity and sensitivity were also analyzed. In the present meta-analysis, 23 articles were allowed for inclusion with total 1,635 patients. Coincidentally, all studies were conducted in Chinese populations. High MMP-9 expression in gliomas was closely associated with high WHO grade (III+IV) (n = 22, OR = 5.25, 95% CI = 4.09-6.73; p = 0.000), while MMP-9 expression did not correlate to age (n = 4, OR = 1.02, 95 % CI = 0.67-1.54; p = 0.929) and gender (n = 5, OR = 0.91, 95% CI = 0.63-1.33; p = 0.632). Besides, overall survival analysis from two articles revealed MMP-9 expression significantly predicted 5-year-OS (HR = 6.44, 95% CI = 3.88-10.70; p = 0.000) in glioma patients. No heterogeneity and publication bias were observed across all studies. To conclude, this meta-analysis suggests MMP-9 is potently associated with high grade and poor 5 years prognosis, and MMP-9 test of glioma tissues should be established in department of pathology as a routine in clinical practice.
authors.affiliation: Department of Pathology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Xiangshan
authors.initials: X
authors.lastname: Yang
authors.forename: Shunzeng
authors.initials: S
authors.lastname: Lv
authors.forename: Yuting
authors.initials: Y
authors.lastname: Liu
authors.forename: Daotang
authors.initials: D
authors.lastname: Li
authors.forename: Ranran
authors.initials: R
authors.lastname: Shi
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Tang
authors.forename: Jianzhen
authors.initials: J
authors.lastname: Fan
authors.forename: Zhongfa
authors.initials: Z
authors.lastname: Xu
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000201:enzymology* / Q000473:pathology*; D016001:Confidence Intervals; D005260:Female; D005910:Glioma / Q000201:enzymology* / Q000473:pathology*; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism*; D008875:Middle Aged; D060787:Neoplasm Grading; D016017:Odds Ratio; D011379:Prognosis; D017594:Publication Bias
chemical_list: D020780:Matrix Metalloproteinase 9
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