Tissue and serum metalloproteinase (MMP-2) expression in advanced ovarian serous cystoadenocarcinomas : Clinical and prognostic implications

Objective : The object of this study was to analyse the tissue and serum metalloproteinase (MMP-2), an enzyme which degrades the basement membrane collagen type IV, as a potential marker useful in prognostics evaluation and clinical monitoring of the follow-up, in patients with advanced ovarian serous cystoadenocarcinoma. Materials and Methods : Tissue MMP-2 expression was determined in 21 FIGO stage III ovarian serous cystoadenocarcinomas treated with primary surgery and adjuvant chemotherapy, and compared to 10 cystoadenomas used as controls. Retrospective analysis of clinical data allowed the comparison of accepted prognostic factors to tissue MMP-2 expression for impact on disease-free survival. In fourteen out of 21 patients, serum MMP-2 levels were also analysed. Results : Compared to cystoadenomas, the tissutal MMP-2 expression was significantly (P<0.001) higher in serous cystoadenocarcinomas. A significant relationship was observed between tissutal MMP-2 and disease-free survival (P=0.0003), independently of tumor architectural grade, lymph nodal status and residual disease after debulking surgery. Recurrence risk in patients whose carcinomas had a tissutal MMP-2 ≥ 29% was significantly higher than that in patients whose carcinomas demonstrated lower tissutal MMP-2 expression (P=0.004). Serum MMP-2 levels correlated with tissutal staining, and also expressed a significant relationship with disease-free survival (P=0.002). Conclusions : Tissue MMP-2 seems to be a prognostic indicator in patients with FIGO stage III ovarian serous cystoadenocarcinoma, significantly correlated with recurrence risk and apparently independent of tumor architectural grade, lymph nodal status, and residual disease after debulking surgery. An interesting relationship was observeded between tissue staining and MMP-2 serum levels.