title: The role of MMP-2 and MMP-9 as prognostic markers in the early stages of tongue squamous cell carcinoma.
abstract: BACKGROUND
  Tongue cancer is the most common intra-oral malignancy with a high rate of morbidity and mortality owing to its increased propensity for tumor invasion and metastasis. These processes require a controlled degradation of the extracellular matrix. Matrix Metalloproteinase-2 (MMP-2) and Matrix Metalloproteinase-9 (MMP-9) are known to be important regulators of matrix lysis and play a significant role in the metastasis of malignancies.
  
  
  OBJECTIVE
  To study the expression of MMP-2 and MMP-9 in the early stages of tongue squamous cell carcinoma and find the association between their expression and local recurrence, metastasis, and survival rates of the subjects.
  
  
  METHODS
  Fifty-nine tumor biopsy samples of tongue squamous cell carcinoma in T1 N0 M0 and T2 N0 M0 stages were immunostained with MMP-2 and MMP-9 antibodies. The immunohistochemical expression was compared with the patient characteristics and outcome.
  
  
  RESULTS
  Cytoplasmic expression of MMP-2 correlated with that of MMP-9 (r = 0.716, P < 0.001). Greater expression of MMP-2 and MMP-9 was observed in patients who subsequently developed local recurrence (P = 0.044 and P < 0.001, respectively), regional and/or distant metastasis (P < 0.001 and P = 0.001, respectively) of the tumor. Further, a higher expression of these biomarkers was associated with shorter survival. MMP-9 was found to have better specificity for local recurrence, metastasis and survival.
  
  
  CONCLUSIONS
  Our results showed that these biomarkers may serve as indicators of a patient's risk potential for poor prognosis and presage the need for more aggressive treatment measures.
authors.affiliation: Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Manikkath
authors.initials: M
authors.lastname: Aparna
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Rao
authors.forename: Vijayanarayana
authors.initials: V
authors.lastname: Kunhikatta
authors.forename: Raghu
authors.initials: R
authors.lastname: Radhakrishnan
mesh_terms: D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000096:biosynthesis*; D020780:Matrix Metalloproteinase 9 / Q000096:biosynthesis*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000201:enzymology* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: early stages; immunohistochemistry; matrix metalloproteinases; prognosis; tongue cancer