High Expression of Matrix Metalloproteinase-11 indicates Poor Prognosis in Human Cholangiocarcinoma

Abstract

<b>Background:</b> Cholangiocarcinoma (CHCA) is serious public health problem in Thailand, especially in thenortheastern and northern regions. CHCA is known as one of the most aggressive malignant tumors associatedwith local invasion and a high rate of metastasis. A crucial step in the invasion process is the proteolytic degradationof the extracellular matrix (ECM) and basal membranes, for which several studies have shown a critical roleplayed by matrix metalloproteinase-11 (MMP-11). <br/><b>Objective</b>: This study aim to detect MMP-11 expression inCHCA specimens and any correlation with survival time. Materials and <br/><b>Methods</b>: A retrospective analysis wasconducted of 30 patients with CHCA in Rajvithi hospital, who had undergone immunohistochemical stainingof MMP-11. Relationships between clinicopathological data and MMP-11 expression in CHCA specimens wereanalyzed by the χ2 test or Fisher’s exact test. The estimated survival and the survival differences were analyzedby the Kaplan-Meier method and the log-rank test, respectively. <br/><b>Results</b>: MMP-11 expression was found in 15specimens (50%). The overall mean survival time is 237.0 days (95% CI 135.4-338.5, SD 271.9). Specimens with apositive MMP-11 had an average survival time of 136.7 days (95%CI 50.3-223.1, SD 156.0). Survival differenceswas signficant for the positive and negative MMP-11(p=0.022), but not well differentiated tumor and moderateto poor differentiated tumor (p=0.755), CA19-9 level of >1,000 and <1,000 (p=0.488), and between advancedand non-advanced staging (p=0.388). <br/><b>Conclusions</b>: The positive MMP-11 expression indicates poor prognosisin CHCA specimens.