Clinical significance of matrix metalloproteinase-9 expression in papillary thyroid carcinoma: a meta-analysis

Abstract

Objective The purpose of this study was to investigate the relationship between the expression of matrix metalloproteinase-9 (MMP-9) and pathological indexes in papillary thyroid carcinoma (PTC). Evidence obtained The database was searched in PubMed, Embase, CNKI, and Web of Science databases for relevant clinical trials. The odds ratio (OR) and 95% confidence interval (CI) show the effect of MMP-9 expression and age, tumour size, gender, lymph node metastasis (LNM), and TNM (tumour, lymph node, metastasis) stage. Statistical analysis of the data was performed using Stata 17.0. Evidence synthesis A total of 1433 patients with PTC were included in this meta-analysis. MMP-9 expression was significantly correlated with LNM (OR = 3.92, 95% CI = 2.71–5.65, P = 0.000), tumour size (OR = 1.69, 95% CI = 1.13–2.52, P = 0.011), and TNM stage (OR = 2.95, 95% CI = 2.10–4.13, P = 0.000), but not with gender (OR = 0.90, 95% CI = 0.66–1.22, P = 0.487) and age (OR = 1.36, 95% CI = 0.93–1.98, P = 0.115). Conclusions Our meta-analysis showed that MMP-9 was significantly associated with LNM, tumour size, and TNM stage; therefore, MMP-9 may be a reliable prognostic biomarker for patients with PTC. However, more high-quality studies are needed to support these findings further.

Matrix Metalloproteinase 9/microRNA-145 Ratio: Bridging Genomic and Immunological Variabilities in Thyroid Cancer

“…Studies have analyzed MMP9 protein and mRNA levels in thyroid tissues using immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), gelatin zymography, Western blotting, and polymerase chain reaction (PCR). Most report significantly higher MMP9 expression in thyroid cancer specimens than in normal tissues or benign nodules [21,[61][62][63][64][65][66][67][68][69][70][71]. Our metaanalysis showed that high MMP9 level is prevalent in 69% (95% CI: 62-77%) of PTC tissue specimens (Figure 11A).…”

“…Dragutinovic et al also found increased MMP9 immunostaining in the more poorly differentiated classical PTC subtype versus the follicular variant [81]. Higher MMP9 levels have additionally been linked to advanced TNM stage in PTC [62,65,67,80], extrathyroidal extension [21,61,64,65,75,79], and larger tumor size [62,65,67] in PTC. Clinically, MMP9 activity distinguishes between sporadic and radiation-induced PTC, with greater MMP9 expression in post-Chernobyl tumors indicating more aggressive disease [82].…”

“…Circulating MMP9 levels have also positively correlated with parameters like tumor size, extrathyroidal extension, lymph node metastasis, advanced TNM stage, distant metastasis, and lymphovascular invasion in PTC patients [65,74,75]. A meta-analysis of 2561 PTC patients confirmed MMP9 overexpression was significantly associated with larger tumor size in PTC (OR: 1.69, 95% CI: 1.13-2.52), higher TNM stage in PTC (OR: 2.95, 95% CI: 2.10-4.13), and lymph node metastasis in PTC (OR: 3.92, 95% CI: 2.71-5.65) [62]. For example, Liu et al found that patients with central/lateral cervical lymph node metastasis had higher MMP9 levels and more advanced TNM stages [77].…”

“…Several studies have examined the associations between MMP9 expression levels and clinicopathological parameters reflective of TC progression and prognosis (Table 6) [23,[61][62][63][64]73,77,78]. Higher MMP9 expression has been consistently associated with the presence of lymph node metastasis compared to PTC without metastasis in multiple studies [21,22,62,65,67,79,80]. Dragutinovic et al also found increased MMP9 immunostaining in the more poorly differentiated classical PTC subtype versus the follicular variant [81].…”