Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China; ; The Second Hospital of Lanzhou University, Lanzhou 730000, China;
The Second Hospital of Lanzhou University, Lanzhou 730000, China;
Chin J Cancer Res. 2013 Dec;25(6):637-45. doi: 10.3978/j.issn.1000-9604.2013.11.03.
Many studies reported that matrix metalloproteinase-9 (MMP-9) participated in the development of esophageal squamous cell carcinoma (ESCC) and resulted in poor prognosis, however, they all included few patients and had inconsistent results. So we conducted a meta-analysis to explore the correlation between overexpression of MMP-9 and the clinicopathological characteristics and overall survival (OS) of ESCC.
PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, Google Scholar and other databases were searched for relevant studies. The Newcastle-Ottawa quality assessment scale was used to assess the methodological quality of included study and RevMan 5.2 software was used to conduct meta-analysis.
A total of 35 studies were included, and the results of meta-analysis showed that overexpression of MMP-9 was associated with grade of differentiation [well/moderate vs. poor: odds ratio (OR): 0.39, 95% confidence interval (CI): 0.29-0.52; P<0.00001], lymph node metastasis (negative vs. positive: OR: 0.24, 95% CI: 0.16-0.34; P<0.00001), TNM stage (T1/T2 vs. T3/T4: OR: 0.28, 95% CI: 0.14-0.54; P=0.0002), the depth of invasion (T1/T2 vs. T3/T4: OR: 0.29, 95% CI: 0.17-0.49; P<0.00001), and vascular invasion of ESCC (negative vs. positive: OR: 0.35, 95% CI: 0.21-0.58; P<0.0001), and also associated with poor overall survival of ESCC (HR: 2.17, 95% CI: 1.32-3.57; P=0.002). Subgroup analysis showed that more than 10% of carcinoma cell staining was associated with significant increase of mortality risk (HR: 2.44, 95% CI: 1.16-5.15; P=0.02), and sensitive analysis suggested that MMP-9 was an independent prognostic factor in ESCC (HR: 1.49, 95% CI: 1.16-1.91; P=0.002).
On the basis of limited evidence, overexpression of MMP-9 may be a potential independent prognosis factor of ESCC patients in Asia, and high-quality studies assessing the prognostic significance of MMP-9 for ESCC patients are still needed.
许多研究报道基质金属蛋白酶-9（MMP-9）参与食管鳞状细胞癌（ESCC）的发展，并导致预后不良，但这些研究纳入的患者较少，结果不一致。因此，我们进行了一项荟萃分析，以探讨 MMP-9 的过表达与 ESCC 的临床病理特征和总生存期（OS）之间的相关性。
检索PubMed、EMBASE、Web of Science、中国生物医学文献数据库、Google Scholar 等数据库，以获取相关研究。采用纽卡斯尔-渥太华质量评估量表对纳入研究的方法学质量进行评估，并采用 RevMan 5.2 软件进行荟萃分析。
共纳入 35 项研究，荟萃分析结果显示，MMP-9 的过表达与分化程度[高/中分化与低分化：比值比（OR）：0.39，95%置信区间（CI）：0.29-0.52；P<0.00001]、淋巴结转移（阴性与阳性：OR：0.24，95%CI：0.16-0.34；P<0.00001）、TNM 分期（T1/T2 期与 T3/T4 期：OR：0.28，95%CI：0.14-0.54；P=0.0002）、肿瘤侵袭深度（T1/T2 期与 T3/T4 期：OR：0.29，95%CI：0.17-0.49；P<0.00001）、ESCC 的血管侵犯（阴性与阳性：OR：0.35，95%CI：0.21-0.58；P<0.0001）有关，并且与 ESCC 的总体生存不良相关（HR：2.17，95%CI：1.32-3.57；P=0.002）。亚组分析显示，超过 10%的癌细胞染色与死亡率显著升高相关（HR：2.44，95%CI：1.16-5.15；P=0.02），敏感性分析表明 MMP-9 是 ESCC 的独立预后因素（HR：1.49，95%CI：1.16-1.91；P=0.002）。
基于有限的证据，MMP-9 的过表达可能是亚洲 ESCC 患者潜在的独立预后因素，仍需要高质量的研究来评估 MMP-9 对 ESCC 患者的预后意义。
