Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
BMC Cancer. 2024 Aug 29;24(1):1065. doi: 10.1186/s12885-024-12775-9.
Matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) are critical components of the extracellular matrix (ECM) in colorectal cancer (CRC). We aimed to evaluate the prognostic value of MMP-2 and MMP-9 in patients with CRC.
We performed a meta-analysis of cohort studies with available data on the effect of MMP-2 and MMP-9 expression on both disease-free survival (DFS) and overall survival (OS) by the risk ratios (RRs) with their 95% confidence intervals (CIs). Studies were subgrouped based on the different tissue types, including cancer tissue and normal tissue, and the subgroup effect of MMP expression in different tissues was analyzed through meta-regression. To ensure the quality and reduce the risk of bias, the Newcastle‒Ottawa Scale (NOS) was used to assess the included studies. A sensitivity analysis was randomly performed to assess the potential impact of each study on our results.
Eighteen trials were selected (Table 1) and included a total of 3944 patients. According to our primary meta-analysis, the expression of MMP-2 was significantly associated with a decrease in OS (RR = 1.75, 95% CI = 1.34 to 2.29, P < 0.001) and DFS (RR = 2.62, 95% CI = 1.25 to 5.49, P < 0.001), and the expression of MMP-9 was not significantly associated with a decrease in OS (RR = 1.48, 95% CI = 0.97 to 2.24, P = 0.069) or DFS (RR = 1.60, 95% CI = 0.87 to 2.94, P = 0.133). According to the subgroup analysis of MMPs in different tissues, high MMP-2 expression in cancer tissue (RR = 1.90, 95% CI = 1.29 to 2.79) and normal tissue (RR = 1.59, 95% CI = 1.17 to 2.17) were significant indicators of poor OS. High MMP-2 expression in cancer tissue was significant indicator of poor DFS (RR = 2.12, 95% CI = 1.09 to 4.11). MMP-9 expression was also associated with poor OS (RR = 1.40, 95% CI = 0.85 to 2.29), but the difference in OS between the high and low expression groups was not statistically significant.
High MMP-2 expression, especially in cancer tissue, is significantly associated with both poor DFS and poor OS in patients with CRC. High MMP-9 expression tended to indicate a poor prognosis of CRC but the correlation was not significant.
基质金属蛋白酶-2（MMP-2）和基质金属蛋白酶-9（MMP-9）是结直肠癌（CRC）细胞外基质（ECM）的关键成分。我们旨在评估 MMP-2 和 MMP-9 在 CRC 患者中的预后价值。
我们通过风险比（RR）及其 95%置信区间（CI），对 MMP-2 和 MMP-9 表达对无病生存（DFS）和总生存（OS）的影响的队列研究进行了荟萃分析。根据不同的组织类型，包括癌组织和正常组织，对研究进行了亚组分析，并通过荟萃回归分析了 MMP 表达在不同组织中的亚组效应。为了确保质量并降低偏倚风险，使用纽卡斯尔-渥太华量表（NOS）对纳入的研究进行评估。我们随机进行了敏感性分析，以评估每项研究对我们结果的潜在影响。
选择了 18 项试验（表 1），共纳入 3944 名患者。根据我们的主要荟萃分析，MMP-2 的表达与 OS（RR=1.75，95%CI=1.34 至 2.29，P<0.001）和 DFS（RR=2.62，95%CI=1.25 至 5.49，P<0.001）的降低显著相关，而 MMP-9 的表达与 OS（RR=1.48，95%CI=0.97 至 2.24，P=0.069）或 DFS（RR=1.60，95%CI=0.87 至 2.94，P=0.133）的降低无显著相关性。根据 MMP 在不同组织中的亚组分析，癌组织中 MMP-2 的高表达（RR=1.90，95%CI=1.29 至 2.79）和正常组织中 MMP-2 的高表达（RR=1.59，95%CI=1.17 至 2.17）是 OS 不良的显著指标。癌组织中 MMP-2 的高表达与 DFS 不良显著相关（RR=2.12，95%CI=1.09 至 4.11）。MMP-9 的表达也与 OS 不良相关（RR=1.40，95%CI=0.85 至 2.29），但高表达组与低表达组之间的 OS 差异无统计学意义。
MMP-2 的高表达，尤其是在癌组织中，与 CRC 患者的 DFS 和 OS 不良均显著相关。MMP-9 的高表达倾向于预示 CRC 的不良预后，但相关性不显著。
