TY - JOUR
T1 - Overexpression of MMP family members functions as prognostic biomarker for breast cancer patients
T2 - A systematic review and meta-analysis
AU - Ren, Fanghui
AU - Tang, Ruixue
AU - Zhang, Xin
AU - Madushi, Wickramaarachchi Mihiranganee
AU - Luo, Dianzhong
AU - Dang, Yiwu
AU - Li, Zuyun
AU - Wei, Kanglai
AU - Chen, Gang
AU - Ahmad, Aamir
N1 - Publisher Copyright:
© 2015 Ren et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2015/8/13
Y1 - 2015/8/13
N2 - Background Matrix metalloproteinases (MMPs) are regarded to be relevant to the prognosis of breast cancer. Numerous studies have confirmed the association between MMPs and tumor growth, invasion and metastasis in breast cancer. However, their prognostic values for survival in patients with breast cancer remain controversial. Hence, a meta-analysis was performed to clarify a more accurate estimation of the role of MMPs on prognosis of breast cancer patients. Method A systemic electronic search was conducted in PubMed, Embase and Web of science databases to identify eligible studies, which were associated with the relationship between MMPs and prognosis of breast cancer. The correlation in random-effect model was evaluated by using the hazard ratios (HRs) and 95% confidence intervals (CIs). Results A total of 28 studies covering 4944 patients were included for meta-analysis. A summary hazard ratio (HR) of all studies was calculated, as well as the sub-group HRs. The combined HRs calculated by either univariate or multivariate analysis both suggested that overexpres-sion of MMPs had an unfavorable impact on overall survival (OS) (HR = 1.694, 95%CI: 1.347-2.129, P < 0.001; HR = 1.611, 95%CI: 1.419-1.830, P < 0.001, respectively). And the univariate analysis showed that patients with overexpression of MMPs had worse relapse-free survival (RFS) (HR = 1.969, 95%CI: 1.460-2.655, P < 0.001) in all eligible studies. In the sub-group analyses, HRs of MMP-9 positivity with poor OS were 1.794 (95%CI: 1.330-2.420, P < 0.001) and 1.709 (95%CI: 1.157-2.526, P = 0.007) which were separately evaluated by univariate and multivariate analysis. A small number of articles demonstrated that MMP-2 overexpression was not related with shorter OS (HR = 1.400, 95%CI: 0.610-3.029, P = 0.427). Four studies included in the OS analysis of MMPs expression in serum suggested that positive expression of serum MMPs may be an unfavorable factor (HR = 1.630, 95%CI: 1.065-2.494) for breast cancer patients. No publication bias was observed in the current meta-analysis. Conclusions Our findings suggested that MMPs overexpression (especially MMP-9, MMP-2, MMPs overexpression in serum) might indicate a higher risk of poor prognosis in breast cancer. Larger prospective studies are further needed to estimate the prognostic values of MMPs overexpression.
AB - Background Matrix metalloproteinases (MMPs) are regarded to be relevant to the prognosis of breast cancer. Numerous studies have confirmed the association between MMPs and tumor growth, invasion and metastasis in breast cancer. However, their prognostic values for survival in patients with breast cancer remain controversial. Hence, a meta-analysis was performed to clarify a more accurate estimation of the role of MMPs on prognosis of breast cancer patients. Method A systemic electronic search was conducted in PubMed, Embase and Web of science databases to identify eligible studies, which were associated with the relationship between MMPs and prognosis of breast cancer. The correlation in random-effect model was evaluated by using the hazard ratios (HRs) and 95% confidence intervals (CIs). Results A total of 28 studies covering 4944 patients were included for meta-analysis. A summary hazard ratio (HR) of all studies was calculated, as well as the sub-group HRs. The combined HRs calculated by either univariate or multivariate analysis both suggested that overexpres-sion of MMPs had an unfavorable impact on overall survival (OS) (HR = 1.694, 95%CI: 1.347-2.129, P < 0.001; HR = 1.611, 95%CI: 1.419-1.830, P < 0.001, respectively). And the univariate analysis showed that patients with overexpression of MMPs had worse relapse-free survival (RFS) (HR = 1.969, 95%CI: 1.460-2.655, P < 0.001) in all eligible studies. In the sub-group analyses, HRs of MMP-9 positivity with poor OS were 1.794 (95%CI: 1.330-2.420, P < 0.001) and 1.709 (95%CI: 1.157-2.526, P = 0.007) which were separately evaluated by univariate and multivariate analysis. A small number of articles demonstrated that MMP-2 overexpression was not related with shorter OS (HR = 1.400, 95%CI: 0.610-3.029, P = 0.427). Four studies included in the OS analysis of MMPs expression in serum suggested that positive expression of serum MMPs may be an unfavorable factor (HR = 1.630, 95%CI: 1.065-2.494) for breast cancer patients. No publication bias was observed in the current meta-analysis. Conclusions Our findings suggested that MMPs overexpression (especially MMP-9, MMP-2, MMPs overexpression in serum) might indicate a higher risk of poor prognosis in breast cancer. Larger prospective studies are further needed to estimate the prognostic values of MMPs overexpression.
UR - http://www.scopus.com/inward/record.url?scp=84943196564&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0135544
DO - 10.1371/journal.pone.0135544
M3 - Article
C2 - 26270045
AN - SCOPUS:84943196564
VL - 10
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - 0135544
ER -
