Upregulated matrix metalloproteinase-2 and downregulated tissue factor pathway inhibitor-2 are risk factors for lymph node metastasis and perineural invasion in pancreatic carcinoma.
BACKGROUND
Dysregulated expression of matrix metalloproteinase (MMP)-2 and tissue factor pathway inhibitor (TFPI)-2 is closely associated with tumorigenesis and tumor progression. The aim of this work was to determine the predictive values of MMP-2 and TFPI-2 in identifying lymph node metastasis (LNM) and perineural invasion (PNI) in pancreatic carcinoma.


METHODS
Formalin-fixed and paraffin-embedded tissue samples containing pancreatic carcinoma tissues and their corresponding para-carcinoma tissues were obtained from 122 patients with pancreatic carcinoma. The expression levels of MMP-2 and TFPI-2 were evaluated by immunohistochemistry. The roles of MMP-2 and TFPI-2 in predicting LNM and PNI in pancreatic carcinoma were analyzed.


RESULTS
The level of MMP-2 expression was markedly increased in pancreatic carcinoma tissues (76.9%) compared with para-carcinoma tissues (29.2%; P<0.05). In contrast, there was obviously decreased TFPI-2 expression level in pancreatic carcinoma tissues (29.2%) compared with para-carcinoma tissues (77.7%; P<0.001). Additionally, MMP-2 expression was significantly positively correlated with LNM (r=0.468, P<0.01) and PNI (r=0.637, P<0.01). In contrast, TFPI-2 expression was strongly negatively correlated with LNM (r=-0.396, P<0.001) and PNI (r=-0.460, P<0.001). Logistic regression analysis showed that high MMP-2 expression and low TFPI-2 expression acted as independent predictors for LNM and PNI in pancreatic carcinoma.


CONCLUSIONS
Taken together, our findings suggest that upregulated MMP-2 and downregulated TFPI-2 serve as useful predictors for a high risk of LNM and PNI. Obtaining information on the expression of MMP-2 and TFPI-2 before surgery may predict the occurrence of LNM and PNI, thereby permitting reasonable and effective surgical treatment for patients with pancreatic carcinoma.
Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China.
Lu-Lu
LL
Zhai
Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China.
Yang
Y
Wu
Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China.
Chong-Yang
CY
Cai
Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China.
Zhi-Gang
ZG
Tang
MMP-2; TFPI-2; immunohistochemistry