Abstract
The objectives of the study were to assess the relationship between the serum levels of MMP-9 and NGAL and the clinical staging and histopathological grade of the tumor. Lipocalin-2/NGAL and MMP-9 concentrations were quantified in serum by multiplex fluorescent bead-based immunoassays (Luminex Corporation, Austin, TX, USA). The AUC values for NGAL and MMP-9 were 0.9 and 0.78, respectively. The diagnostic potential of NGAL and MMP-9 in differentiating high-stage (FIGO III and IV) and low-stage (FIGO I and II) cancer and predicting the cell differentiation grade (G1 versus G3) on the basis of the analyses of AUC values was determined to be 0.91 and 0.79 for NGAL and 0.82 and 0.84 for MMP-9, respectively. Multifactorial logistic regression analysis in the final method revealed that NGAL and MMP-9 variables were independent of the endometrial cancer risk. OR values for NGAL and MMP-9 were 1.23 (95% CI 1.421–3.27; p = 0.034) and 1.09 (95% CI: 1.38–4.12; p = 0.026), respectively. The NGAL/MMP-9 complex may be useful in the assessment of tumor stage before surgical treatment.
Highlights
Endometrial cancer is one of the most common types of tumors
No analogous correlations were observed between the BMI values or blood glucose levels and the serum levels of MMP-9
Blood glucose levels in patients with type 2 diabetes were shown to be correlated with serum NGAL levels (r = 0 64); no correlation was observed between the NGAL levels and the blood pressure measurements
Summary
Endometrial cancer is one of the most common types of tumors. According to Globocan data, about 320,000 new cases of endometrial cancer were recorded in 2012 [1]. The incidence rates in developed countries cannot be reduced. This is associated largely to the prevalence or endometrial cancer risk factors such as obesity, hypertension, and diabetes [2]. The 5-year survival rate in treated patients with low-stage endometrial cancer is about 80%. No single protein was found that could be considered an independent prognostic factor in endometrial cancer. Recent publications reported high expression of metalloproteinases in endometrial tumors. Metalloproteinases are a group of extracellular endopeptidases involved in the degradation of extracellular matrix. MMP-9 is an extracellular enzyme degrading the extracellular matrix and the basal membrane [3]. Lipocalin-2 is a protein comprising a risk factor of insulin resistance and diabetes [4, 5].
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