Erhöhte Expression von Matrix Metalloproteinase 9 (MMP-9) korreliert mit ungünstiger Prognose bei operablen nicht-kleinzelligen Bronchialkarzinomen

Abstract

The present study was performed to investigate the clinical impact of increased MMP-9 expression on early tumor cell dissemination and long-term survival in patients with operable NSCLC.

Primary tumors of 147 consecutive patients with completely resected NSCLC were examined for MMP-9 expression by immunohistochemical staining. Specimens that showed positive staining at least similar to the internal positive control in at least 95% of cancer cells were considered positive concerning increased expression of MMP-9. Data about minimal dissemination into regional lymph nodes and minimal dissemination into bone marrow was available in 86 and 90 patients, respectively, and was included into analysis of the clinical impact of increased MMP-9 expression.

Increased expression of MMP-9 was observed in 26 of 143 patients (18.2%) and did not correlate with clinicopathological parameters (4 specimens were excluded due to unspecific staining). Increased MMP-9 expression was an independent prognostic parameter for unfavorable outcome: Log rank analysis showed a significant association with shortened cancer-related survival (p = 0.04) and multivariate regression analysis revealed an independence of this prognostic impact (p = 0.03). In adenocarcinoma of the lung, increased MMP-9 expression was associated with minimal dissemination into lymph nodes and bone marrow (p = 0.01 and 0.05, respectively; chi-square test).

The present study revealed that increased MMP-9 expression predicts a poor prognosis in non-small cell lung cancer and correlates with dissemination of individual tumor cells in adenocarcinoma of the lung. This type of study may provide a basis for studies that examine the value of MMP-9 increased expression for the preselection of patients to be included in trials to investigate adjuvant therapy after surgery for NSCLC.