基质金属蛋白酶-2及其抑制物与大肠癌恶性生物学行为的关系

目的探讨基质金属蛋白酶-2(MMP-2)及其抑制物(TIMP-2)表达与大肠癌恶性生物学行为的关系.方法采用S-P免疫组化染色技术检测30例大肠腺瘤、60例大肠癌组织MMP-2和TIMP-2的表达情况.结果 MMP-2的表达率在大肠腺瘤中为26.7%(8/30),显著低于大肠癌中的86.7%(52/60)(P<0.05);其表达与大肠癌的Dukes分期、分化程度、淋巴结转移和生存期均密切相关(P值均<0.05);本组大肠癌Dukes B期比例较高,其总体TIMP-2表达在腺瘤和本组大肠癌之间差异无显著性(P>0.05),TIMP-2表达与大肠癌的Dukes分期、淋巴结转移、远隔脏器转移及生存期均有关(P值均<0.05).结论 MMP-2和TIMP-2的检测可作为临床判断大肠癌的恶性程度、转移及预后的重要参考指标.     

血清中 MMP-9、TIMP-1表达水平与肺癌病理特征的关系分析

目的：检测肺癌患者血清MMP-9、TIMP-1水平变化,探讨其与肺癌患者病理特征的关系。方法选取80例肺癌患者为研究对象,另选取30例正常健康者为对照组,ELISA法测定肺癌患者及正常者血清中MMP-9、TIMP-1水平,比较两组之间差异。结果肺癌患者血清MMP-9、TIMP-1水平均显著高于正常者（ P＜0．01）,肺癌患者血清中MMP-9、TIMP-1表达水平与肺癌病理类型、病理分化程度无关（P＞0．05）,与肿瘤体积大小、TNM分期、淋巴结转移、远处转移相关,肿瘤≥3 cm患者血清中MMP-9、TIMP-1水平明显高于肿瘤≤3 cm的患者;Ⅲ＋Ⅳ期患者血清中MMP-9、TIMP-1水平明显高于Ⅰ＋Ⅱ期患者;淋巴结转移患者血清中MMP-9、TIMP-1水平明显高于无淋巴结转移患者;远处转移患者血清中MMP-9、TIMP-1水平明显高于无远处转移患者;肺癌患者MMP-9表达与TIMP-1表达呈正相关（γ＝0．634,P＜0．05）。结论 MMP-9、TIMP-1在肺癌患者中表达与TNM分期、淋巴结转移、远处转移相关,在肺癌侵袭转移中有重要作用,可监测病情发展。     

基质金属蛋白酶及其组织抑制物在卵巢肿瘤中的表达

背景与目的：有研究表明,基质金属蛋白酶（metalloproteinases,MMPs）与肿瘤的发生发展,尤其是肿瘤细胞的侵袭和转移密切相关。本研究探讨基质金属蛋白酶MMP－2、MMP－9及其组织抑制物（tissue inbibitor of metalloproteinases-2,TIMP-2）与卵巢癌侵袭及卵巢癌生物学行为的关系。方法：采用免疫组化S－P法对128例卵巢肿瘤组织MMP－2、MMP－9及TIMP－2蛋白表达进行检测,并用Χ^2检验进行统计学分析。结果：免疫组化结果表明,MMP－2、MMP－9及TIMP－2在卵巢癌组织中阳性表达率明显高于卵巢囊腺瘤（P＜0．01）。MMP－2及MMP－9在卵巢癌临床分期Ⅲ-Ⅳ期病例中的阳性表达率明显高于I－Ⅱ期者,病理学分级3级病例中的表达率明显高于1－2级者（P＜0．01）,有淋巴结转移病例中的表达率明显高于无淋巴结转移者（P＜0．01）。而TIMP－2的阳性表达与MMP－2及MMP－9相反。结论：MMP－2、MMP－9及TIMP－2的表达与卵巢癌的临床分期、病理分级及淋巴结转移有关,MMP－2及MMP－9蛋白的高表达可作为判断卵巢部具有转移倾向的临床参考指标。     

Prognostic significance of MMP-9 and TIMP-1 serum and tissue expression in breast cancer

Tumor progression and metastasis contribute to the great majority of breast cancer deaths. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are thought to be involved in tumor progression and metastasis. Thus, we determined whether the expression of MMP-9 and TIMP-1 is associated with prognosis in breast cancer patients. We measured serum MMP-9 and TIMP-1 by enzyme-linked immunosorbent assay in 60 breast cancer patients, 18 benign breast disease patients and 15 healthy controls. We also evaluated the expression of MMP-9 and TIMP-1 protein and mRNA in paraffin-embedded tumor tissues from the 60 breast cancer patients by immunohistochemistry and in situ hybridization. We then correlated serum and tissue levels of MMP-9 and TIMP-1 in breast cancer samples and their expression with patients' clinicopathologic characteristics. We found that serum levels of MMP-9 and TIMP-1 were significantly higher in breast cancer patients than in benign breast disease and in healthy controls. High serum levels of MMP-9 and TIMP-1 were associated with lymph node metastasis, higher tumor stage and lower relapse-free and overall survival (OS) rates. Compared to low expression, high tissue expression of MMP-9 protein was associated with lymph node metastasis and higher tumor stage; and high tissue expression of TIMP-1 was associated with a lower OS rate. Our findings suggest that MMP-9 and TIMP-1 may further be evaluated as biomarkers for predicting progression and prognosis of breast cancer.     

Prognostic significance of matrix metalloproteinases-1, -2, -7 and -13 and tissue inhibitors of metalloproteinases-1, -2, -3 and -4 in colorectal cancer

Strong expression of many matrix metalloproteinases (MMPs) has been related to poor survival of colorectal cancer (CRC) patients. The expression of tissue inhibitors of metalloproteinases (TIMPs) has been associated with both a beneficial and a poor outcome and there is thus a need to further clarify the significance of MMPs and TIMPs in CRC. The prognostic significance of 4 MMPs and TIMPs in CRC was evaluated. Formalin-fixed, paraffin-embedded tissue arrayed samples of 351 patients with primary colon or rectal cancer of Dukes' stages A-D were selected for immunohistochemical staining of MMP-1, -2, -7 and -13, and TIMP-1, -2, -3 and -4. High expression of MMP-2 in the malignant epithelium as well as in the surrounding stroma was associated with reduced survival of colon cancer patients. Strong epithelial and stromal cytoplasmic staining of TIMP-3 was associated with a longer survival in rectal cancer patients, and here the interobserver variation for evaluating the degree of staining was lower than for epithelial staining. Strong stromal cytoplasmic staining of TIMP-4 predicted longer survival of rectal cancer patients. Multivariate analysis showed that stromal cytoplasmic TIMP-3 staining was the only marker of independent prognostic value. MMP-2 might be a useful prognostic marker in colon cancer, and TIMP-3 and TIMP-4 in rectal cancer, but the findings associated with stromal staining should be interpreted with some caution. Different biologic behavior or different genetic development may explain the differences between colon and rectal cancers regarding the expression of MMP-2, TIMP-3 and TIMP-4.     

The expression of MMP-2 and TIMP-2 in patients with primary colorectal adenocarcinoma: correlation with liver metastasis.

The expression of MMP-2 and TIMP-2 was examined immunohistochemically in a total of 36 colorectal cancer patients with synchronous liver metastasis at the time of surgery, and the serum MMP-2 and TIMP-2 levels were also measured in a total of 58 colorectal cancer patients with/without liver metastasis following primary colorectal surgical resection for serological comparison. Although MMP-2 exhibited a significant expression immunohistochemically in the primary colorectal cancer (p<0.05) and TIMP-2 in the synchronous liver metastasis (p<0.01), there was no relationship between the absence/presence of liver metastasis and serum MMP-2 and TIMP-2 levels, respectively. These results suggest that it can be considered difficult to use serum MMP-2 and TIMP-2 levels to predict the status of liver metastasis following primary resection in patients with colorectal adenocarcinoma.     

Expression of tissue inhibitor of metalloproteinases TIMP-2 in human colorectal cancer--a predictor of tumour stage.

The aim of this study was to investigate whether immunohistochemical staining patterns of tissue inhibitor of metalloproteinases TIMP-2 and matrix metalloproteinases MMP-2 and MMP-9 can be predictors of tumour stage and survival time in colorectal cancer. Frozen tumour sections from 212 patients operated on between January 1987 and November 1990 were investigated. Three mouse monoclonal antibodies--T2-101 against TIMP-2, CA-4001 against MMP-2 and GE-213 against MMP-9--were used. Positive expression of TIMP-2 (a) in basement membranes and (b) diffusely in stroma with (c) subglandular enhancement was found significantly (P < 0.01, P < 0.05, P < 0.05) more often in localized tumours than in tumours with regional or distant metastases. Neither pattern correlated with tumour differentiation. Patterns (a) and (c) correlated with longer survival time (P < 0.05); (b) reached near significance (P < 0.07). When the survival analyses were restricted to potentially cured patients, neither pattern could foretell death from cancer. Positive expression of MMP-2 in tumour epithelium and of MMP-9 in tumour-infiltrating macrophages were both independent of tumour stage and were without correlation with survival time. A large number of MMP-9-positive macrophages correlated (P < 0.05) with poor tumour differentiation, whereas weak or absent epithelial MMP-2 staining reached near significance (P < 0.08). Exploration of TIMP-2 expression is valuable for the discrimination between macroscopically localized and metastatic colorectal cancer, but it cannot predict which of the potentially cured patients are likely to have micrometastases. MMP-2 and MMP-9 stainings are of minor value in staging and prognostic prediction.     

Clinical relevance of MMP-9, MMP-2, TIMP-1 and TIMP-2 in colorectal cancer

The main aim of this study was to evaluate the clinical relevance of Gelatinases in colorectal cancer (CRC). Ninety-five CRCs and their paired normal tissues were investigated to detect total levels of MMP-9, MMP-2, and the tissue inhibitors TIMP-1 and TIMP-2. Also, pro-MMP and MMP activity, and potential associations with clinical parameters were estimated. MMP-9, MMP-2 and TIMP-1 levels were greater in CRCs than in normal tissues, differences being significant for MMP-9 and TIMP-1. However, TIMP-2 showed significantly lower levels in tumour samples. Moreover, significant differences in the state of activation between gelatinases were found. TIMP-1 low levels were significantly associated with poor clinical outcome of patients. According to these data, different roles have to be attributed to MMP-2 and MMP-9 in CRC progression. Moreover, TIMP-1 level evaluation emerges as the main prognostic factor in relation to Gelatinases A and B activity in CRC.     

Loss of basement membrane type IV collagen is associated with increased expression of metalloproteinases 2 and 9 (MMP-2 and MMP-9) during human colorectal tumorigenesis.

Breakdown of basement membrane (BM) is believed to be an essential step for tumor invasion and metastases. We have previously demonstrated that matrix metalloproteinase-9 (MMP-9), the 92 kDa collagenase expression correlates with metastases in human colorectal cancer (CRC). This study explores the relationship between the 72 and 92 kDa type IV collagenase (MMP-2 and MMP-9) activities and pattern of type IV collagen expression during human colorectal tumorigenesis. Thirty-four CRC patients, including four synchronous adenomas and one synchronous liver metastases, were involved in this study. By immunohistochemical staining, type IV collagen expression was noted to be continuous in the BM of normal mucosa, adenoma and in two cases of carcinoma in situ. Limited or absent type IV collagen staining pattern was seen in 100 (19/19) and 23% (3/13) of CRC with and without metastases, respectively. By double immunostaining, MMP-9 protein expression was noted to localize within areas of limited type IV collagen staining. Similarly, type IV collagen staining was noted to be greatest in areas devoid of MMP-9 expression. Gelatin zymography detected both 92 and 72 kDa proenzyme forms in all CRC and normal mucosa extracts examined. The mean tumor/normal fold increases of the proMMP-2 and proMMP-9 enzyme forms were 1.6+/-0.1 (mean +/- SE) and 2.4+/-0.5 in adenomas, and 2.1+/-0.2 and 4.1+/-0.7 in CRC, respectively. The 62 and 82 kDa bands were present in 63 (12/19) and 74% (14/19) of CRC with metastases, compared with only 20 (3/15) and 33% (5/15) of CRC without metastases, respectively. These differences were significant (P = 0.045 and P = 0.030, respectively). Our results demonstrate that loss of BM type IV collagen along with elevations in MMP-2 and MMP-9 expression, especially the activated forms, occur during colorectal tumorigenesis. Our data suggest that control of type IV collagenase activation may be beneficial in preventing human colorectal tumor progression.     

Expression and localization of matrix metalloproteinases and tissue inhibitors of metalloproteinases as a prognostic factor in advanced colorectal carcinomas

To clarify the usefulness of matrix metallo-proteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) as prognostic factors in advanced colorectal carcinoma, the immunohistochemical expressions of MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1 and TIMP-2 were examined. Specimens were selected from 67 consecutive patients undergoing surgery for advanced colorectal carcinoma. The patterns of expression were compared with the prognoses of the patients. The patients with TIMP-2 expression in stroma adjacent to the tumor mass had better prognoses than those of the patients who had no TIMP-2 expression in normal stroma adjacent to the tumor (p<0.05), which probably acted as a block of cancer cell invasion. However, the expression of MMP-2, presumably acting as an antagonist to TIMP-2 was not related to the prognosis, and the MMP-1, MMP-2, MMP-3, MMP-9 and TIMP-1 expressions were not related to any clinicopathological factors examined.     

Distinct pattern of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 mRNA expression in human colorectal cancer and liver metastases.

The matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are perceived as essential for tumour invasion and metastasis. In the present study, we compare the topographical pattern of MMP-9 and TIMP-1 expression in colorectal cancer and liver metastasis by in situ hybridisation. TIMP-1 mRNA was detected in all 26 colorectal cancers examined, while only 18 out of 26 (69.2%) were positive for MMP-9. Both MMP-9 and TIMP-1 mRNA were observed in all ten liver metastases but were absent in three adenomas and in all normal colonic mucosa and liver. There was no association between MMP-9 or TIMP-1 mRNA expression and degree of differentiation or size of Tumours. MMP-9 and TIMP-1 mRNA were similarly observed in the peritumour stroma cells rather than in tumour cells themselves. MMP-9 mRNA positive cells were round and identified as macrophages by immunostaining with an anti-macrophage antibody (KP1), while TIMP-1, mRNA was detected in spindle-shaped stromal cells. In liver metastases, MMP-9 localised within peritumour stroma or at the interface between the tumour stroma and normal liver, whereas TIMP-1 mRNA was located throughout the malignant tumour stroma. Our data demonstrate a distinct pattern of MMP-9 and TIMP-1 mRNA expression in colorectal cancer and liver metastases suggesting distinct cellular origins as well as separate patterns of regulation.     

Circulating gelatinases and tissue inhibitor of metalloproteinase-1 in colorectal cancer metastatic liver disease.

AIMS: The degradation of the extracellular matrix is intrinsic to the invasion and progression of cancer. Matrix metalloproteinase (MMP)-2 and -9 and their natural inhibitors are involved in this process. The study aims to investigate if plasma MMP-2, -9 and tissue inhibitor of metalloproteinase-1 (TIMP-1) can be useful markers in the diagnosis and prognosis of colorectal cancer (CRC) metastatic liver disease. METHODS: Fifty-seven patients undergoing liver metastasis operation were followed prospectively. ProMMP-2, -9 and TIMP-1 plasma levels were determined by zymography and ELISA, before and after the resection of liver metastases. Data were compared with those of healthy controls (n=51) and primary CRC patients (n=94). The diagnostic and prognostic potential was investigated with ROC-curves and Kaplan-Meier survival analysis. RESULTS: Plasma proMMP-2 levels were lower (P<0.001), and TIMP-1 levels higher (P<0.001) in CRC metastatic liver disease than in healthy controls. If compared to those in primary CRC patients, no differences were found. In ROC-curves, the area under the curve was 0.48 and 0.61 for proMMP-2 and -9, respectively. Plasma proMMP-2, -9 and TIMP-1 levels were unsuitable to predict survival. In both diagnostic and prognostic examinations, CEA proved to be a better marker. In the postoperative follow-up, protracted low levels of proMMP-2 seemed related to disease recurrence. CONCLUSION: The preoperative plasma proMMP-2, -9 and TIMP-1 levels have no potential value as diagnostic or prognostic markers in CRC liver metastatic disease.     

Treatment of colorectal liver metastases by adenoviral transfer of tissue inhibitor of metalloproteinases-2 into the liver tissue

Metastatic disease is the leading cause of death in cancer patients. Here, we describe a novel gene therapeutic strategy for prevention of metastatic spread by providing a suitable defense mechanism for the target organ. The production of metalloproteinase (MMP) enzymes by cancer cells is critical for local invasion and for infiltration of metastatic cells into distant sites. Using a nude mouse model of colorectal liver metastasis, we have overexpressed the MMP inhibitor, tissue inhibitor of MMP-2 (TIMP-2) in the liver prior to, or following, tumor challenge by metastatic LS174T cells in vivo. Transduction of approximately 50% of hepatocytes resulted in 95% reduction in metastasis after tumor challenge compared with controls. Furthermore, TIMP-2 gene transfer into livers with preexisting metastatic spread resulted in a 77% reduction in tumor cell growth. Our data imply that MMP activity of metastatic cancer cells is required for spread and subsequent tumor growth and that enhancing antiproteolytic defense mechanisms in target organs represents a novel form of cancer gene therapy.     

Study of matrix metalloproteinases and their inhibitors in breast cancer

An immunohistochemical study was performed using tissue microarrays and specific antibodies against matrix metalloproteinases (MMPs) 1, 2, 7, 9, 11, 13, 14, and their tisullar inhibitors (TIMPs) 1, 2, and 3. More than 2600 determinations on cancer specimens from 131 patients with primary ductal invasive tumours of the breast (65 with and 66 without distant metastasis) and controls were performed. Staining results were categorised using a score based on the intensity of the staining and a specific software program calculated the percentage of immunostained cells automatically. We observed a broad variation of the total immunostaining scores and the cell type expressing each protein. There were multiple and significant associations between the expression of the different MMPs and TIMPs evaluated and some parameters indicative of tumour aggressiveness, such as large tumour size, advanced tumour grade, high Nottinham prognostic index, negative oestrogen receptor status, peritumoural inflammation, desmoplastic reaction, and infiltrating tumoural edge. Likewise, the detection of elevated immunohistochemical scores for MMP-9, 11, TIMP-1, and TIMP-2, was significantly associated with a higher rate of distant metastases. The expression of MMP-9 or TIMP-2 by tumour cells, MMP-1, 7, 9, 11, 13, or TIMP-3 by fibroblastic cells, and MMP-7, 9, 11, 13, 14, TIMP-1, or TIMP-2 by mononuclear inflammatory cells, was also significantly associated with a higher rate of distant metastases.     

Matrix Metalloproteinase-2 (-1306 C>T) Promoter Polymorphism and Risk of Colorectal Cancer in the Saudi Population

Background: Matrix metalloproteinase-2 (MMP-2) is an enzyme with proteolytic activity against matrixproteins, particularly basement membrane constituents. A single nucleotide polymorphism (SNP) at -1306,which disrupts a Sp1-type promoter site (CCACC box), results in strikingly lower promoter activity with theT allele. In the present study, we investigated whether this MMP-2 genetic polymorphism might be associatedwith susceptibility to colorectal cancer (CRC) in the Saudi population. We also analyzed MMP-2 gene expressionlevel sin CRC patients and 4 different cancer cell lines. Materials and Methods: TaqMan allele discriminationassays and DNA sequencing techniques were used to investigate the C-1306T SNP in the MMP-2 gene of Saudicolorectal cancer patients and controls. The MMP-2 gene expression level was also determined in 12 coloncancer tissue samples collected from unrelated patients and histologically normal tissues distant from tumormargins. Results and Conclusions: The MMP-2 C-1306T SNP in the promoter region was associated with CRC inour Saudi population and the MMP-2 gene expression level was found to be 10 times higher in CRC patients.The MMP-2 C-1306T SNP is significantly associated with CRC in the Saudi population and this finding suggestedthat MMP-2 variants might help predict CRC progression risk among Saudis. We propose that analysis of thisgene polymorphism could assist in identification of patient subgroups at risk of a poor disease outcome.     

Assay of matrix metalloproteinase levels and their endogenous inhibitors in patients with laryngeal carcinoma

Levels of matrix metalloproteinase (MMP-2) and endogenous inhibitors (TIMP-1,-2) in tumor and blood serum from patients with squamous-cell laryngeal carcinoma were studied. Immunohistochemical investigation showed much higher MMP-9 expression (76.9%) and TIMP-1 (100%) in tumor tussue than MMP-2 (23.8%) and TIMP-2 (33.3%). Therefore, MMP-9 and TIMP-1 levels in blood serum alone were assayed. TIMP-1 levels in serum from patients were significantly higher than those in healthy subjects (p=0.023). High TIMP-1 levels in blood serum were recorded in patients with stage III laryngeal carcinoma and differed significantly from control (p=0.009). However, no correlation was found between them and MMP concentration in blood serum, on the one hand, and tumor size, on the other. High TIMP-1 levels in blood serum were recorded in patients free from metastasis to regional lymph nodes (124.5+39.5 ng/ml); however, they were lower than in those with such metastases (102.7+10.9 ng/ml) and significantly lower than in healthy subjects (p=0.023). There was a correlation between MMP-9 expression in tumor tissue, on the one hand, and involvement of regional lymph nodes, on the other, (p=0.054). In blood serum from patients showing tumor regression by 75-100% after radiotherapy, TIMP-1 levels were higher than in those with relatively lower response to the same treatment (p=0.072). Hence, assay of TIMP-1 levels in blood serum and MMP-9 concentration in tumor tissue may be used for assessment of tumor processes alongside standard procedures. Moreover, the former may be instrumental in predicting laryngeal response to radiotherapy.     

Expression of MMP-3 and TIMP-3 in gastric cancer tissue and its clinical significance

The present study aimed to investigate the expression of matrix metalloproteinase-3 (MMP-3) and the tissue inhibitor of metalloproteinase-3 (TIMP-3) in gastric cancer tissue, as well as to analyze the correlation between their expression and the occurrence of gastric cancer. Immunohistochemistry was used to determine the expression of MMP-3 and TIMP-3 in the gastric cancer tissue from 18 patients with early-stage gastric cancer (early-stage group) and 26 patients with advanced-stage gastric cancer (advanced-stage group). Transmission electron microscopy (TEM) was used to observe the lymphocytes and tumor cells in gastric cancer tissue. The results showed that the expression of TIMP-3 was significantly higher, whereas that of MMP-3 and MMP-3/TIMP-3 was lower in gastric cancer tissue of the early-stage group than in that of the advanced-stage group (P<0.05). The TEM images revealed increased lymphocytes and inconspicuous tumor cells penetrating the basement membrane in gastric cancer tissue of the early-stage group, and decreased lymphocytes and obvious tumor cells penetrating the basement membrane in the advanced-stage group. In conclusion, MMP-3 and TIMP-3 may be used as indices for the invasion and metastasis of gastric cancer and possess marked clinical significance in the prognostic judgment of gastric cancer.