Article Data

  • Views 946
  • Dowloads 169

Original Research

Open Access Special Issue

Prognostic value of matrix metalloproteinase 2 protein expression in ovarian cancer is age- and stage-dependent

  • Mourad Assidi1,2
  • Mohammad Alam Jafri1,2
  • Muhammad Abu-Elmagd1,2
  • Salina Saddi3
  • Safia Messaoudi4
  • Mahmood Rasool1,2
  • Jaudah AlMaghrabi5
  • Nisreen Anfinan6
  • Hanen Chelbi7
  • Maram Sait8
  • Abdelfatteh El Omri9
  • Hesham Sait6
  • Hussain Basalamah6
  • Khalid Sait6
  • Abdelbaset Buhmeida1,*,

1Center of Excellence in Genomic Medicine Research, King Abdulaziz University, 21589 Jeddah, Saudi Arabia

2Medical Laboratory Department, Faculty of Applied Medical Sciences, King Abdulaziz University, 21589 Jeddah, Saudi Arabia

3Biological Sciences Department, Faculty of Science, King Abdulaziz University, 21589 Jeddah, Saudi Arabia

4Department of Forensic Sciences, College of Criminal Justice, Naif Arab University for Security Sciences, 14812 Riyadh, Saudi Arabia

5Department of Pathology, Faculty of Medicine, King Abdulaziz University Hospital, 21589 Jeddah, Saudi Arabia

6Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University Hospital, 21589 Jeddah, Saudi Arabia

7Laboratoire de Parasitologie-Mycologie, Pasteur Institute of Tunis, 1002 Tunis, Tunisia

8Faculty of Medicine, King Abdulaziz University Hospital, 21589 Jeddah, Saudi Arabia

9Surgical Research Section, Department of Surgery, Hamad Medical Corporation, 55867 Doha, Qatar

DOI: 10.31083/j.ejgo4301010 Vol.43,Issue 1,February 2022 pp.26-35

Submitted: 12 September 2021 Accepted: 17 November 2021

Published: 15 February 2022

*Corresponding Author(s): Abdelbaset Buhmeida E-mail: abuhme@utu.fi

Abstract

Objective: Matrix metalloproteinase 2 (MMP2) has been associated with tumor development and invasion; however, the information available regarding its prognostic value in ovarian cancer (OC), especially in the Arabian Peninsula, is limited. The aim of this retrospective study was to analyze MMP2 protein expression and assess its prognostic value. Methods: In total, 245 formalin-fixed and paraffin-embedded (FFPE) primary OC tissue samples were randomly collected from patients with available clinicopathological data, including disease of all stages and all histological subtypes. MMP2 protein expression was measured using automated tissue microarray and immunohistochemistry techniques. Statistical analyses were performed using SPSS, with p << 0.05 considered statistically significant. Results: Cytoplasmic MMP2 protein expression patterns were higher in 53% of all tumor samples. The MMP2 expression profile was not significantly correlated with most clinicopathological features including age, tumor site, size, grade, and lymph node status (p >> 0.05). However, when adjusted according to the disease stage or patient age, MMP2 overexpression showed a significant indication of a poor outcome and recurrence as evaluated using univariate Kaplan–Meier analysis for disease-free survival (DFS) (p = 0.04 and p = 0.03, respectively, log-rank test), but not for disease-specific survival (DSS) (p >> 0.05, log-rank test). Conclusion: This study showed that MMP2 protein overexpression was a negative prognosticator in Saudi OC patients with advanced stage and/or young age. These results could pave the way towards more effective and personalized detection, prognosis, and management of OC.


Keywords

Ovarian cancer; Matrix metalloproteinase; MMP2; Prognosis; Tissue microarray; Age; Stage


Cite and Share

Mourad Assidi,Mohammad Alam Jafri,Muhammad Abu-Elmagd,Salina Saddi,Safia Messaoudi,Mahmood Rasool,Jaudah AlMaghrabi,Nisreen Anfinan,Hanen Chelbi,Maram Sait,Abdelfatteh El Omri,Hesham Sait,Hussain Basalamah,Khalid Sait,Abdelbaset Buhmeida. Prognostic value of matrix metalloproteinase 2 protein expression in ovarian cancer is age- and stage-dependent. European Journal of Gynaecological Oncology. 2022. 43(1);26-35.

References

[1] Prasad V. Perspective: the precision-oncology illusion. Nature. 2016; 537: S63–S63.

[2] Grunewald T, Ledermann JA. Targeted Therapies for Ovarian Cancer. Best Practice & Research. Clinical Obstetrics & Gynaecology. 2017; 41: 139–152.

[3] Fields EC, McGuire WP, Lin L, Temkin SM. Radiation Treatment in Women with Ovarian Cancer: Past, Present, and Future. Frontiers in Oncology. 2017; 7: 177–177.

[4] Fu Z, Xu S, Xu Y, Ma J, Li J, Xu P. The Expression of Tumor-Derived and Stromal-Derived Matrix Metalloproteinase 2 Predicted Prognosis of Ovarian Cancer. International Journal of Gynecological Cancer. 2015; 25: 356–362.

[5] Torre LA, Trabert B, DeSantis CE, Miller KD, Samimi G, Runowicz CD, et al. Ovarian cancer statistics, 2018. CA: A Cancer Journal for Clinicians. 2018; 68: 284–296.

[6] Jeleniewicz W, Cybulski M, Nowakowski A, Stenzel-Bembenek A, Guz M, Marzec-Kotarska B, et al. MMP-2 mRNA Expression in Ovarian Cancer Tissues Predicts Patients’ Response to Platinum-Taxane Chemotherapy. Anticancer Research. 2019; 39: 1821–1827.

[7] Saudi Cancer Registry S. Cancer Incidence Report Saudi Arabia 2013. Saudi Cancer Registry. 2016; 1–88.

[8] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018; 68: 394–424.

[9] Kalmantis K, Rodolakis A, Daskalakis G, Antsaklis A. Characterization of ovarian tumors and staging ovarian cancer with 3- dimensional power Doppler angiography: correlation with pathologic findings. International Journal of Gynecological Cancer. 2013; 23: 469–474.

[10] Banach P, Suchy W, Dereziński P, Matysiak J, Kokot ZJ, Nowak-Markwitz E. Mass spectrometry as a tool for biomarkers searching in gynecological oncology. Biomedicine & Pharmacotherapy. 2017; 92: 836–842.

[11] Rose PG, Java JJ, Morgan MA, Alvarez-Secord A, Kesterson JP, Stehman FB, et al. Disease extent at secondary cytoreductive surgery is predictive of progression-free and overall survival in advanced stage ovarian cancer: an NRG Oncology/Gynecologic Oncology Group study. Gynecologic Oncology. 2016; 143: 511–515.

[12] Uysal M, Ozdogan M, Kargi A, Gunduz S, Sezgin Goksu S, Murat Tatli A, et al. Prolonged progression-free survival with maintenance metronomic oral cyclophosphamide and etoposide treatment in macroscopic residual disease or recurrent/advanced stage ovarian cancer. Journal of B.U.ON. 2014; 19: 980–984.

[13] Clark TG, Stewart M, Rye T, Smyth JF, Gourley C. Validation of a New Prognostic Index for Advanced Epithelial Ovarian Cancer: Results from its Application to a UK-Based Cohort. Journal of Clinical Oncology. 2007; 25: 5669–5670.

[14] Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA: A Cancer Journal for Clinicians. 2012; 62: 10–29.

[15] Oldenhuis CNAM, Oosting SF, Gietema JA, de Vries EGE. Prognostic versus predictive value of biomarkers in oncology. European Journal of Cancer. 2008; 44: 946–953.

[16] El Bairi K, Amrani M, Kandhro AH, Afqir S. Prediction of therapy response in ovarian cancer: where are we now? Critical Reviews in Clinical Laboratory Sciences. 2017; 54: 233–266.

[17] Wang J, Chen L, Zhou X. Identifying prognostic signature in ovarian cancer using DirGenerank. Oncotarget. 2017; 8: 46398–46413.

[18] Birkedal-Hansen H, Moore WG, Bodden MK, Windsor LJ, Birkedal-Hansen B, DeCarlo A, et al. Matrix metalloproteinases: a review. Critical Reviews in Oral Biology and Medicine. 1993; 4: 197–250.

[19] Sheu BC, Lien HC, Ho HN, Lin HH, Chow SN, Huang SC, et al. Increased expression and activation of gelatinolytic matrix metalloproteinases is associated with the progression and recurrence of human cervical cancer. Cancer Research. 2003; 63: 6537–6542.

[20] Guo C, Wang S, Deng C, Zhang D, Wang F, Jin X. Relation-ship between matrix metalloproteinase 2 and lung cancer progression. Molecular Diagnosis & Therapy. 2007; 11: 183–192.

[21] Wang M, Li L, Liu J, Wang J. A gene interaction networkbased method to measure the common and heterogeneous mechanisms of gynecological cancer. Molecular Medicine Reports. 2018; 18: 230–242.

[22] Li Y, Wang X, Wang X, Wan L, Liu Y, Shi Y, et al. PDCD4 suppresses proliferation, migration, and invasion of endometrial cells by inhibiting autophagy and NF-kappaB/MMP2/MMP9 signal pathway. Biology of Reproduction. 2018; 99: 360–372.

[23] Sakata K, Shigemasa K, Nagai N, Ohama K. Expression of matrix metalloproteinases (MMP-2, MMP-9, MT1-MMP) and their inhibitors (TIMP-1, TIMP-2) in common epithelial tumors of the ovary. International Journal of Oncology. 2000; 17: 673–681.

[24] Wang X, Yang B, She Y, Ye Y. The lncRNA TP73-as1 promotes ovarian cancer cell proliferation and metastasis via modulation of MMP2 and MMP9. Journal of Cellular Biochemistry. 2018; 119: 7790–7799.

[25] Xu F, Si X, Wang J, Yang A, Qin T, Yang Y. Nectin-3 is a new biomarker that mediates the upregulation of MMP2 and MMP9 in ovarian cancer cells. Biomedicine & Pharmacotherapy. 2019; 110: 139–144.

[26] Wu W, Gao H, Li X, Peng S, Yu J, Liu N, et al. Β-hCG promotes epithelial ovarian cancer metastasis through ERK/MMP2 signaling pathway. Cell Cycle. 2019; 18: 46–59.

[27] Li X, Bao C, Ma Z, Xu B, Ying X, Liu X, et al. Perfluorooctanoic acid stimulates ovarian cancer cell migration, invasion via ERK/NF-kappaB/MMP-2/-9 pathway. Toxicology Letters. 2018; 294: 44–50.

[28] Huang K, Sui L. The relevance and role of vascular endothelial growth factor C, matrix metalloproteinase-2 and E-cadherin in epithelial ovarian cancer. Medical Oncology. 2012; 29: 318–323.

[29] Jia H, Zhang Q, Liu F, Zhou D. Prognostic value of MMP-2 for patients with ovarian epithelial carcinoma: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics. 2017; 295: 689–696.

[30] Liu H, Zeng Z, Wang S, Li T, Mastriani E, Li Q, et al. Main components of pomegranate, ellagic acid and luteolin, inhibit metastasis of ovarian cancer by down-regulating MMP2 and MMP9. Cancer Biology & Therapy. 2017; 18: 990–999.

[31] Zhang J, Liu L, Wang J, Ren B, Zhang L, Li W. Formononetin, an isoflavone from Astragalus membranaceus inhibits proliferation and metastasis of ovarian cancer cells. Journal of Ethnopharmacology. 2018; 221: 91–99.

[32] Al-Maghrabi J, Emam E, Gomaa W, Saggaf M, Buhmeida A, Al-Qahtani M, et al. C-MET immunostaining in colorectal carcinoma is associated with local disease recurrence. BMC Cancer. 2015; 15: 676.

[33] Nedjadi T, Buhmeida A, Assidi M, Al-Ammari A, Al-Sayyad A, Hussain SA, et al. The prognostic significance of her2/neu, p27 and sonic hedgehog proteins in urothelial cell carcinoma of the bladder in Saudi Arabia. Journal of Clinical Oncology. 2016; 34: e16020–e16020.

[34] Buhmeida A, Dallol A, Merdad A, Al-Maghrabi J, Gari MA, Abu-Elmagd MM, et al. High fibroblast growth factor 19 (FGF19) expression predicts worse prognosis in invasive ductal carcinoma of breast. Tumor Biology. 2014; 35: 2817–2824.

[35] Buhmeida A, Assidi M, Al-Maghrabi J, Dallol A, Sibiany A, Al-Ahwal M, et al. Membranous or Cytoplasmic her2 Expression in Colorectal Carcinoma: Evaluation of Prognostic Value Using both IHC & BDISH. Cancer Investigation. 2018; 36: 129–140.

[36] Lipponen PK, Collan Y. Simple quantitation of immunohisto-chemical staining positivity in microscopy for histopathology routine. Acta Stereologica. 1992; 11: 125–132.

[37] Buhmeida A, Elzagheid A, Algars A, Collan Y, Syrjänen K, Pyrhönen S. Expression of the cell-cell adhesion molecule beta-catenin in colorectal carcinomas and their metastases. Acta Pathologica, Microbiologica, et Immunologica Scandinavica. 2008; 116: 1–9.

[38] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. Ca-a Cancer Journal for Clinicians. 2020; 70: 7–30.

[39] Liu Z, Zhang T, Zhao J, Qi S, Du P, Liu D, et al. The association between overweight, obesity and ovarian cancer: a meta-analysis. Japanese Journal of Clinical Oncology. 2015; 45: 1107–1115.

[40] Park J, Morley TS, Kim M, Clegg DJ, Scherer PE. Obesity and cancer—mechanisms underlying tumour progression and recurrence. Nature Reviews. Endocrinology. 2014; 10: 455–465.

[41] Tworoger SS, Huang T. Obesity and Ovarian Cancer. Recent Results in Cancer Research. Fortschritte Der Krebsforschung. Progres Dans Les Recherches Sur Le Cancer. 2016; 208: 155–176.

[42] Sopik V, Iqbal J, Rosen B, Narod SA. Why have ovarian cancer mortality rates declined? Part i. Incidence. Gynecologic Oncology. 2015; 138: 741–749.

[43] Beral V, Doll R, Hermon C, Peto R, Reeves G. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet. 2008; 371: 303–314.

[44] Gong T, Wu Q, Vogtmann E, Lin B, Wang Y. Age at menarche and risk of ovarian cancer: a meta-analysis of epidemiological studies. International Journal of Cancer. 2013; 132: 2894–2900.

[45] Cai KQ, Yang W, Capo-Chichi CD, Vanderveer L, Wu H, God-win AK, et al. Prominent expression of metalloproteinases in early stages of ovarian tumorigenesis. Molecular Carcinogene-sis. 2007; 46: 130–143.

[46] Egeblad M, Werb Z. New functions for the matrix metallopro-teinases in cancer progression. Nature Reviews. Cancer. 2002; 2: 161–174.

[47] Kenny HA, Kaur S, Coussens LM, Lengyel E. The initial steps of ovarian cancer cell metastasis are mediated by MMP-2 cleavage of vitronectin and fibronectin. The Journal of Clinical Investigation. 2008; 118: 1367–1379.

[48] Wu X, Li H, Kang L, Li L, Wang W, Shan B. Activated matrix metalloproteinase-2—a potential marker of prognosis for epithelial ovarian cancer. Gynecologic Oncology. 2002; 84: 126–134.

[49] Al-Alem L, Curry TE. Ovarian cancer: involvement of the matrix metalloproteinases. Reproduction. 2015; 150: R55–R64.

[50] Torng P, Mao T, Chan W, Huang S, Lin C. Prognostic significance of stromal metalloproteinase-2 in ovarian adenocarcinoma and its relation to carcinoma progression. Gynecologic Oncology. 2004; 92: 559–567.

[51] Wang L, Jin X, Lin D, Liu Z, Zhang X, Lu Y, et al. Clinico-pathologic significance of claudin-6, occludin, and matrix metalloproteinases -2 expression in ovarian carcinoma. Diagnostic Pathology. 2013; 8: 190.

[52] Périgny M, Bairati I, Harvey I, Beauchemin M, Harel F, Plante M, et al. Role of immunohistochemical overexpression of matrix metalloproteinases MMP-2 and MMP-11 in the prognosis of death by ovarian cancer. American Journal of Clinical Pathology. 2008; 129: 226–231.

[53] Chaffer CL, Weinberg RA. A perspective on cancer cell metastasis. Science. 2011; 331: 1559–1564.

[54] Kleiner DE, Stetler-Stevenson WG. Structural biochemistry and activation of matrix metalloproteases. Current Opinion in Cell Biology. 1993; 5: 891–897.

[55] Murphy G, Knäuper V, Cowell S, Hembry R, Stanton H, Butler G, et al. Evaluation of some newer matrix metalloproteinases. Annals of the New York Academy of Sciences. 1999; 878: 25–39.

[56] Ray JM, Stetler-Stevenson WG. Gelatinase a activity directly modulates melanoma cell adhesion and spreading. The EMBO Journal. 1995; 14: 908–917.

[57] Bourboulia D, Stetler-Stevenson WG. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs): Positive and negative regulators in tumor cell adhesion. Seminars in Cancer Biology. 2010; 20: 161–168.

[58] Furuya M, Ishikura H, Kawarada Y, Ogawa Y, Sakuragi N, Fujimoto S, et al. Expression of matrix metalloproteinases and related tissue inhibitors in the cyst fluids of ovarian mucinous neoplasms. Gynecologic Oncology. 2000; 78: 106–112.

[59] Zeng L, Qian J, Zhu F, Wu F, Zhao H, Zhu H. The prognostic values of matrix metalloproteinases in ovarian cancer. Journal of International Medical Research. 2020; 48: 030006051982598.

[60] Zhang Y, Chen Q. Relationship between matrix metalloproteinases and the occurrence and development of ovarian cancer. Brazilian Journal of Medical and Biological Research. 2017; 50: e6104.

[61] Kessenbrock K, Plaks V, Werb Z. Matrix metalloproteinases: regulators of the tumor microenvironment. Cell. 2010; 141: 52–67.

[62] Schröpfer A, Kammerer U, Kapp M, Dietl J, Feix S, Anacker J. Expression pattern of matrix metalloproteinases in human gynecological cancer cell lines. BMC Cancer. 2010; 10: 553.

[63] Westerlund A, Apaja-Sarkkinen M, Höyhtyä M, Puistola U, Turpeenniemi-Hujanen T. Gelatinase a-immunoreactive protein in ovarian lesions- prognostic value in epithelial ovarian cancer. Gynecologic Oncology. 1999; 75: 91–98.

[64] Kamat AA, Fletcher M, Gruman LM, Mueller P, Lopez A, Landen CN, et al. The Clinical Relevance of Stromal Matrix Metal-loproteinase Expression in Ovarian Cancer. Clinical Cancer Research. 2006; 12: 1707–1714.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time

Conferences

Top