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- Title
Comprehensive Analysis of the Prognostic Value of Circulating MMP-7 Levels in Urothelial Carcinoma: A Combined Cohort Analysis, Systematic Review, and Meta-Analysis.
- Authors
Kubik, András; das Virgens, Isabel Pinto Amorim; Szabó, Anett; Váradi, Melinda; Csizmarik, Anita; Keszthelyi, Attila; Majoros, Attila; Fehérvári, Péter; Hegyi, Péter; Ács, Nándor; Nyirády, Péter; Szarvas, Tibor
- Abstract
Lymph node (LN) status is the most significant prognostic factor for invasive urothelial bladder cancer (UBC); however, the optimal extent of LN dissection (LND) is debated. We assessed circulating matrix metalloproteinase-7 (MMP-7) as a prognostic factor and decision-making marker for the extent of LND. Preoperative serum MMP-7 levels were determined in two independent UBC cohorts (n = 188; n = 68) and in one control cohort (n = 97) by using the ELISA method. A systematic review and meta-analysis on the prognostic role of circulating pretreatment MMP-7 levels were performed. Serum MMP-7 levels were higher in patients compared to controls (p < 0.001) with the highest levels in LN-positive cases. Half of LN-positive UBC patients had low MMP-7 levels, whereas the survival of LN-negative patients with high serum MMP-7 findings was poor. MMP-7 levels were independently associated with poor survival in both cohorts (p = 0.006, p < 0.001). Accordingly, our systematic review of six eligible publications revealed a 2.5-fold higher mortality risk in patients with high MMP-7 levels. In conclusion, preoperative MMP-7 level is a validated and independent prognostic factor in urothelial cancer. It cannot be used to decide between regional or extended LND but may be useful in identifying LN-negative high-risk patients with potentially undetected metastases.
- Subjects
MATRIX metalloproteinases; TRANSITIONAL cell carcinoma; PROGNOSIS; COHORT analysis; CANCER prognosis
- Publication
International Journal of Molecular Sciences, 2023, Vol 24, Issue 9, p7859
- ISSN
1661-6596
- Publication type
Article
- DOI
10.3390/ijms24097859