Abstract
So far, the prognostic value of matrix metalloproteinase 2 (MMP-2) and tissue inhibitor of matrix metalloproteinase 2 (TIMP-2) expressions in patients with gliomas has been widely reported, especially in China. But, the results were inconsistent. Thus, we conducted a meta-analysis to determine the correlation of MMP-2 and TIMP-2 expressions with the prognosis of patients with gliomas. Identical search strategies were used to search relevant literature in electronic databases updated to May 1, 2015, and odds ratios (ORs) with 95 % confidence intervals (95 % CIs) were estimated. Funnel plots and Egger’s tests were conducted for the evaluation of publication bias, and heterogeneity and sensitivity were also analyzed. Finally, a total of 25 studies involving 1572 patients were included in the meta-analysis. Coincidentally, all these studies were conducted in Chinese population. It was found that MMP-2 expression was significantly associated with high-WHO grade gliomas (n = 24, OR = 6.54, CI = 4.98–8.60; I2 = 0 %, P = 0.911) and poor overall survival (OS), while it did not correlate to age (n = 2, OR = 0.78, CI = 0.35–1.74; I2 = 0 %, P = 0.621) and gender (n = 2, OR = 1.15, CI = 0.51–2.62; I2 = 0 %, P = 0.995). Moreover, the results of the pooled analysis indicated that there was no association between TIMP-2 expression and the WHO grade of gliomas (n = 7, OR = 1.02, 95 % CI = 0.68–1.54; I2 = 71.4 %, P = 0.002), but the ratio of MMP-2 and TIMP-2 (MMP-2/TIMP-2) rose with the increase of the WHO grade of gliomas. In conclusion, there was no correlation between TIMP-2 expression and the WHO grade of gliomas, while MMP-2 expression was potently associated with high-WHO grade of gliomas.
Highlights
Gliomas are the most common primary central nervous system tumor, whose treatment mainly comprises surgical resection, postoperative radiotherapy, and chemotherapy [1, 2]
25 studies were included in the meta-analysis, of which 24 studies were related to Matrix metalloproteinases (MMPs)-2 and gliomas and seven studies for tissue inhibitors of MMPs (TIMPs)-2 and
In our meta-analysis, the results of 24 studies involving 1453 patients demonstrated that the expression of Matrix metalloproteinase 2 (MMP-2) in patients with high-grade gliomas increased significantly as compared to patients with low-grade gliomas, while no correlation was observed between MMP-2 and age, and no association was found between MMP-2 and gender
Summary
Gliomas are the most common primary central nervous system tumor, whose treatment mainly comprises surgical resection, postoperative radiotherapy, and chemotherapy [1, 2]. According to the World Health Organization, gliomas are divided into four clinical grades (I–IV) based on the morphology of histopathology [3]. It is indispensable to identify precise biomarkers with predictive value for the grading of gliomas and identification of the survival status of patients. Matrix metalloproteinases (MMPs) are a family of enzymes which play a direct role in the tumorigenesis process [6]. Type IV collagen is the main component of extracellular matrix (ECM) and basement membrane which form the first vital barrier in the course of tumor metastasis. Matrix metalloproteinase 2 (MMP-2), a main member of MMPs, by its ability to degrade the basement membrane type IV collagen, is thought to play a role in stromal and vascular invasion by tumor cells [7, 8]. TIMP2 which is a member of TIMPs has a unique dual function that
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