Matrix metalloproteinases‐2 and ‐9 in cervical cancer: different roles in tumor progression

The incidence of uterine cervical cancer has increased slightly in Western countries, with an increase in relatively young women. Overexpression of matrix metalloproteinases (MMPs)‐2 and ‐9 has turned out as a prognostic factor in many cancers. We compared the expression of the proteins MMP‐2 and MMP‐9 in cervical primary tumors with clinical outcome and risk factors of cervical cancer. One hundred sixty‐one patients with cervical cancer treated in Umeå University Hospital or Sahlgrenska University Hospital, Sweden, between 1991 and 1995 were included in the study. Paraffin‐embedded tissue samples obtained prior to treatment were examined immunohistochemically by specific antibodies for MMP‐2 and MMP‐9. Forty‐two percent of the tumors were intensively positive for MMP‐2 and 31% for MMP‐9. Nineteen percent of the samples were intensively positive for both proteinases and 47% negative or weak for both. Overexpression of MMP‐2 seemed to predict unfavorable survival under Kaplan–Meier analysis and in the multivariate analysis. Early sexual activity and low parity seemed to correlate to overexpression of MMP‐2. MMP‐9 was not associated with survival or sexual behavior. Intensive MMP‐9 was noted in grade 1 tumors. We conclude that MMP‐2 and MMP‐9 have different roles in uterine cervical cancer. MMP‐2 could be associated with aggressive behavior, but MMP‐9 expression diminishes in high‐grade tumors.