Clinicopathological significance of matrix metalloproteinase7 expression in ampullary cancer

Abstract

MMP7 is associated with poor prognosis in different cancers. It is highly expressed in pancreatic cancer. There are no data on MMP7 expression in ampullary carcinoma which is more common than pancreatic cancer in the Indian population. We studied MMP7 expression in ampullary cancer and correlated with clinicopathological variables. Consecutive ampullary carcinomas were reviewed for intestinal and pancreatobiliary differentiation using morphology and immunohistochemistry (CDX2, MUC2, CK20, MUC1, CK7, CK17). MMP7 expression was correlated with clinicopathological features. Ampullary carcinomas (91) were classified as intestinal (36), pancreatobiliary (44), mixed (6), adenosquamous (1), signet ring cell (2) and undifferentiated carcinoma (2). MMP7 expression was seen in 58 cases of which 26 were intestinal and 23 pancreatobiliary. MMP7 expression was more in T1-stage tumors (<i>p</i>=0.03). Median survival was lower in patients with MMP7 expression (28 months) than loss (45 months). MMP7 negative pancreatobiliary cancers with MMP7 loss had higher median survival (21 months) than with MMP7 expression (12 months) (<i>p</i>=0.05). This is first study to show MMP7 expression in ampullary cancer and its correlation with histological differentiation. MMP7 expression was associated with low T-stage tumors and lower survival. MMP7 expression can be evaluated as one of the targets for adjuvant therapy as in pancreatic cancers.