Murray NP, Reyes E, Salazar A, Lopez MA, Orrego S, Guzman E. The expression of matrix-metalloproteinase-2 in bone marrow micro-metastasis is associated with the presence of circulating prostate cells and a worse prognosis in men treated with radical prostatectomy for prostate cancer.
Turk J Urol 2020;
46:186-195. [PMID:
32401703 DOI:
10.5152/tud.2020.19219]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 01/21/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE
The expression of matrix-metalloproteinase-2 (MMP-2) in the primary tumor is associated with a worse prognosis but little is known at this time regarding the expression in micro-metastasis, the association with circulating prostate cells (CPCs), and outcome.
MATERIAL AND METHODS
This was a prospective study of men undergoing radical prostatectomy. Bone marrow and blood samples were taken at one month after surgery. Micro-metastasis and CPCs were identified using immunocytochemistry with anti-prostate specific-antigen and MMP-2 expression determined with anti-MMP-2. Pathological stage, Gleason score, and time to biochemical failure were recorded; meanwhile, Kaplan-Meier biochemical failure-free survival and restricted mean biochemical failure-free survival times for 10 years were determined.
RESULTS
A total of 282 men participated, 54 (19%) of whom had micro-metastasis but not CPCs (group B) and 88 (31%) of whom had micro-metastasis and CPCs (group C). Men in group C had a higher frequency of MMP-2 expressing micro-metastasis at 63% versus 12% (p<0.001), and MMP-2 expression in bone marrow micro-metastasis was associated with a higher Gleason score (p<0.05) as well as a higher frequency of and shorter time to treatment failure. Also, a 10-year Kaplan-Meier biochemical failure-free survival rate of 0% versus 7.7% (MMP-2 positive versus negative) and a mean time to biochemical failure of 2.6 versus 4.0 years were recorded.
CONCLUSION
The expression of MMP-2 in bone marrow micro-metastasis is associated with a higher Gleason score, the presence of CPCs, and a higher frequency of and shorter time to failure and could be clinically useful for identifying men at high risk of treatment failure.
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