title: Prognostic impact of serum and tissue MMP-9 in non-small cell lung cancer: a systematic review and meta-analysis.
abstract: Matrix metalloproteinases-9 (MMP-9) was one of the most important enzyme to breakdown extracellular matrix, aim to clarify the prognostic value of MMP-9 in non-small cell lung cancer (NSCLC), we investigated the serum MMP-9 of NSCLC patients and performed a meta-analysis of the published literature. The expression and activity of serum MMP-9 were assessed by ELISA and gelatin zymography in 163 NSCLC patients. Moreover, 26 studies were included in meta-analysis by searching Medline and ISI Web of Knowledge. Our own data revealed high activity but not expression of MMP-9 significantly correlated with advanced T category and positive metastasis. In contrast, the meta-analysis revealed that increased MMP-9 level indicate high T category (RR = 0.83, 95% CI: 0.73-0.94), tumor stage (RR = 0.72, 95% CI: 0.63-0.82) and poor OS (5-year overall survival, RR = 1.32, 95% CI: 1.19-1.48). Moreover, stratified analysis based on sample types found that high MMP-9 expression in tissue specimen but not serum was significant correlated with advanced T category (RR = 0.81, 95% CI: 0.72-0.92), tumor stage (RR = 0.69, 95% CI: 0.60-0.80) and poor 5-year OS (1.33, 95% CI: 1.18-1.50).In conclusion, the activity of MMP-9 was positively correlated with advanced T category and distant metastasis. Moreover, the meta-analysis revealed that overexpression of MMP-9 in tissue but not in serum was a risk factor of advanced T category, tumor stage and poor outcome.
authors.affiliation: Department of Otorhinolaryngology, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi 315300, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Gong
authors.affiliation: Department of Thoracic surgery, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi 315300, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Otorhinolaryngology, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi 315300, China.
authors.forename: Jianding
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Otorhinolaryngology, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi 315300, China.
authors.forename: Jianqiang
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi 315300, China.
authors.forename: Liangyu
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Oncology, Zhejiang Provincial People's Hospital, Hangzhou 310004, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310004, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ni
authors.affiliation: Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310004, China.
authors.forename: Hongjun
authors.initials: H
authors.lastname: Yuan
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000201:enzymology* / Q000473:pathology; D018572:Disease-Free Survival; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000201:enzymology* / Q000473:pathology; D020780:Matrix Metalloproteinase 9 / Q000097:blood / Q000378:metabolism*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: ELISA; immunohistochemistry; matrix metalloprotease-9; non-small cell lung cancer