Immunohistochemical analysis of matrix metalloproteinase‑9 predicts papillary thyroid carcinoma prognosis

Abstract

The present study aimed to explore the association between immunohistochemical matrix metalloproteinase-9 (MMP-9) expression and the clinicopathological characteristics of patients with papillary thyroid carcinoma (PTC), and to determine whether it may be used as a diagnostic or prognostic tool for PTC. Immunohistochemical staining of MMP-9 was performed in thyroid tissues obtained from 112 patients with PTC and 42 subjects with benign thyroid nodules (BTNs). The receiver operating characteristic curve was used to evaluate the legitimacy of MMP-9 as a diagnostic tool for PTC, and a predictor for structurally persistent/recurrent disease (SPRD) and disease status. Cox regression was applied to identify the risk factors of disease status and SPRD. The present study revealed that MMP-9 was overexpressed in PTC tissues, compared with in BTN tissues. Furthermore, MMP-9 scores yielded an area under the curve (AUC) of 0.842 (95% CI, 0.776–0.908) for differentially diagnosing PTC from BTN. In addition, the MMP-9 score was greater if patients previously had central lymph node metastasis, lateral lymph node metastasis or an advanced tumor-node-metastasis stage (III+IV). When MMP-9 was employed to predict disease status and SPRD, an AUC of 0.811 (95% CI, 0.706–0.917) and 0.806 (95% CI, 0.620–0.992) was obtained, respectively. A tumor size of >2 cm and an MMP-9 staining score of ≥6 were independent risk factors for predicting disease status, whereas vascular invasion and an MMP-9 staining score of ≥8 were risk factors for predicting SPRD. Furthermore, an MMP-9 staining score of ≥6 and ≥8 indicated shortened disease-free survival and survival without SPRD, respectively. In conclusion, the assessment of MMP-9 expression in thyroid carcinoma samples may represent a potential and supplementary tool for the diagnosis and prognostic prediction of PTC.

Role of CXCR4 and MMP-9 Expressions with Regional Cervical Lymph Nodes Metastatic Status in Papillary Thyroid Carcinoma

“…The result of this study was consistent with a study by Liu et al [23] which also found a significant correlation between MMP-9 expression and central and lateral lymph node metastasis in the late-stage PTC (stage III-IV) (p < 0.05). A study by Hwang et al [24] investigating MMP-9 in gastric cancer, also reported a similar result where MMP-9 was correlated with lymph node metastasis and lymphatic invasion, and bad prognosis.…”

“…Previous studies have shown MMP-9 to have good sensitivity and specificity for the diagnosis of PTC [23].…”

“…"Free" NF-κβ will migrate into the cell nucleus to play a role in the protein translation process. The activity of NF-κβ induces the expression of MMP-9 leading to cell proliferation, angiogenesis, and metastasis of tumor cells [23,32].…”

Role of matrix metalloproteinases and their inhibitors in the development of cervical metastases in papillary thyroid cancer

“…Previous researches have highlighted the particular association of MMP‐1, MMP‐2 and MMP‐9 with local invasiveness, angiogenesis and metastatic potential of certain malignant tumours . Generally, studies that investigate expressions of MMPs and TIMPs in PTC are focused mainly on differentiating malignant from benign thyroid nodules . The present study is focused exclusively on metastatic PTC and is investigating differences in expression among certain metastatic groups.…”

“…7,13 Generally, studies that investigate expressions of MMPs and TIMPs in PTC are focused mainly on differentiating malignant from benign thyroid nodules. 14 The present study is focused exclusively on metastatic PTC and is investigating differences in expression among certain metastatic groups.…”