Plasma MMP1 and MMP8 expression in breast cancer: Protective role of MMP8 against lymph node metastasis

Julie Decock¹ , Wouter Hendrickx¹^,2 , Ulla Vanleeuw¹ , Vanya Van Belle³ , Sabine Van Huffel³ , Marie-Rose Christiaens² , Shu Ye⁴ and Robert Paridaens¹^,2

¹Laboratory for Experimental Oncology (LEO), K.U.Leuven, Campus University Hospital Gasthuisberg, O&N1 bus 815, Herestraat 49, 3000 Leuven, Belgium

²Multidisciplinary Breast Centre (MBC), University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium

³Department of Electrical Engineering (ESAT), Division SCD, K.U.Leuven, Kasteelpark Arenberg 10 bus 2446, 3001 Leuven, Belgium

⁴Clinical Pharmacology, William Harvey Research Institute, John Vane Science Building, Charthouse Square, London EC1M 6BQ, UK

author email corresponding author email

BMC Cancer 2008, 8:77doi:10.1186/1471-2407-8-77


Published:	20 March 2008

Abstract

Background

Elevated levels of matrix metalloproteinases have been found to associate with poor prognosis in various carcinomas. This study aimed at evaluating plasma levels of MMP1, MMP8 and MMP13 as diagnostic and prognostic markers of breast cancer.

Methods

A total of 208 breast cancer patients, of which 21 with inflammatory breast cancer, and 42 healthy controls were included. Plasma MMP1, MMP8 and MMP13 levels were measured using ELISA and correlated with clinicopathological characteristics.

Results

Median plasma MMP1 levels were higher in controls than in breast cancer patients (3.45 vs. 2.01 ng/ml), while no difference was found for MMP8 (10.74 vs. 10.49 ng/ml). ROC analysis for MMP1 revealed an AUC of 0.67, sensitivity of 80% and specificity of 24% at a cut-off value of 4.24 ng/ml. Plasma MMP13 expression could not be detected. No correlation was found between MMP1 and MMP8 levels. We found a trend of lower MMP1 levels with increasing tumour size (p = 0.07); and higher MMP8 levels with premenopausal status (p = 0.06) and NPI (p = 0.04). The median plasma MMP1 (p = 0.02) and MMP8 (p = 0.007) levels in the non-inflammatory breast cancer patients were almost twice as high as those found in the inflammatory breast cancer patients. Intriguingly, plasma MMP8 levels were positively associated with lymph node involvement but showed a negative correlation with the risk of distant metastasis. Both controls and lymph node negative patients (pN0) had lower MMP8 levels than patients with moderate lymph node involvement (pN1, pN2) (p = 0.001); and showed a trend for higher MMP8 levels compared to patients with extensive lymph node involvement (pN3) and a strong predisposition to distant metastasis (p = 0.11). Based on the hypothesis that blood and tissue protein levels are in reverse association, these results suggest that MMP8 in the tumour may have a protective effect against lymph node metastasis.

Conclusion

In summary, we observed differences in MMP1 and MMP8 plasma levels between healthy controls and breast cancer patients as well as between breast cancer patients. Interestingly, our results suggest that MMP8 may affect the metastatic behaviour of breast cancer cells through protection against lymph node metastasis, underlining the importance of anti-target identification in drug development.