Swellam Menha, Arab Lobna R Ezz El, Bushnak Hussein A
Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt.
IUBMB Life. 2007 Jun;59(6):394-401. doi: 10.1080/15216540701395074.
The aggressive biological behavior of invasive and metastatic cancer is considered to be the most insidious and life-threatening aspect for breast cancer patients. It is mostly the result of changes in many molecular characteristics of tumor cells, including alterations in gene expression and the balance of proteolytic activity. The objective of this study was to determine the level of MMP-2, its natural inhibitor TIMP-2, their ratio and HER-2/neu as diagnostic and prognostic factors. Markers were analyzed in 240 tissue samples categorized into 96 benign breast disease and 144 breast cancer patients. Enzyme linked immunosorbent assay procedure was used to evaluate the level of MMP-2 and TIMP-2 in the cell lysate, HER-2/neu in the membrane fraction, and steroid hormone receptors (ER and PgR) in the cytosol fraction. Breast cancer patients were followed-up for three years. Receiver operating characteristic curves were used to determine the cutoff points for the investigated factors. Positive values for all investigated factors were significantly increased in breast cancer patients compared to benign ones. Mean levels for all investigated factors were significantly correlated with lymph node and hormone receptor status, while MMP-2 and TIMP-2 were correlated with tumor grade (P < 0.05). In Univariate analysis, positive MMP-2, MMP-2/TIMP-2, HER-2/neu overexpression, higher tumor grade, late clinical stages and positive lymph nodes status were significantly associated with relapse. By multivariate analysis, all aforementioned factors apart from tumor grade were independent variables. Thus, the investigated markers are constructive for biologic aggressiveness of breast cancer and MMP-2/TIMP-2 ratio might be a new significant marker in early diagnosis and estimate prognosis in breast cancer.
浸润性和转移性癌症的侵袭性生物学行为被认为是乳腺癌患者最隐匿且危及生命的方面。这主要是肿瘤细胞许多分子特征发生变化的结果,包括基因表达改变和蛋白水解活性平衡的改变。本研究的目的是确定基质金属蛋白酶-2(MMP-2)水平、其天然抑制剂金属蛋白酶组织抑制因子-2(TIMP-2)、它们的比值以及人表皮生长因子受体2(HER-2/neu)作为诊断和预后因素的情况。对240份组织样本中的标志物进行了分析,这些样本分为96例良性乳腺疾病和144例乳腺癌患者。采用酶联免疫吸附测定法评估细胞裂解液中MMP-2和TIMP-2的水平、膜部分中HER-2/neu的水平以及胞质部分中类固醇激素受体(雌激素受体和孕激素受体)的水平。对乳腺癌患者进行了三年的随访。采用受试者工作特征曲线来确定所研究因素的截断点。与良性患者相比,所有研究因素的阳性值在乳腺癌患者中均显著升高。所有研究因素的平均水平与淋巴结和激素受体状态显著相关,而MMP-2和TIMP-2与肿瘤分级相关(P<0.05)。单因素分析中,MMP-2阳性、MMP-2/TIMP-2、HER-2/neu过表达、较高肿瘤分级、临床晚期和阳性淋巴结状态与复发显著相关。多因素分析显示,除肿瘤分级外,上述所有因素均为独立变量。因此,所研究的标志物对乳腺癌的生物学侵袭性具有参考价值,MMP-2/TIMP-2比值可能是乳腺癌早期诊断和评估预后的一个新的重要标志物。