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 seru m metalloproteinase (MMP-2), an enzyme which degrades the basement mem brane collagen type IV, as a potential marker useful in prognostic eva luation and clinical monitoring of the follow-lip, in patients with ad vanced ovarian serous cystoadenocarcinoma. Materials and Methods: Tiss ue MMP-2 expression was determined in 21 FIGO stage III ovarian serous cystoadenocarcinomas treated with primary surgery and adjuvant chemot herapy, and compared to 10 cystoadenomas used as controls. Retrospecti ve analysis of clinical data allowed the comparison of accepted progno stic factors to tissue MMP-2 expression for impact on disease-free sur vival. In fourteen out of 21 patients serum MMP-2 levels were also ana lysed 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 disea se-free survival (P=0.0003), independently of tumor architectural grad e, lymph nodal status and residual disease after debulking surgery. Re currence risk in patients whose carcinomas had a tissutal MMP-2 greate r than or equal to 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 expr essed a significant relationship with disease-free survival (P=0.002). Conclusions: Tissue MMP-2 seems to be a prognostic indicator in patie nts with FIGO stage III ovarian serous cystoadenocarcinoma, significan tly correlated with recurrence risk and apparently independent of tumo r architectural grade, lymph nodal status, and residual disease after debulking surgery. An interesting relationship was observed between ti ssue staining and MMP-2 serum levels.