The Impact of Matrix Metalloproteinase 2 on Prognosis and Clinicopathology of Breast Cancer Patients: A Systematic Meta-Analysis

<div><p>Backgrounds</p><p>Matrix metalloproteinase 2 (MMP-2) plays a crucial role in the progression of breast cancer (BC). The prognostic role of MMP-2 expression in BC patients has been widely reported, but the results were inconsistent. Thus, a meta-analysis was conducted to gain a better insight into the impact of MMP-2 expression on survival and clinicopathological features of BC patients.</p><p>Methods</p><p>Identical search strategies were used to search relevant literatures in electronic databases update to August 1, 2014. Individual hazard ratios (HRs) and odds ratios (ORs) with their 95% confidence intervals (CIs) were extracted and pooled to evaluate the strength of the association between positive MMP-2 expression and survival results and clinicopathological features of BC patients. Begg’s tests, Egger’s tests and funnel plots were used to evaluate publication bias. Heterogeneity and sensitivity analysis were also assessed. All the work was completed using STATA.</p><p>Results</p><p>Pooled HRs and 95% CIs suggested that MMP-2 expression had an unfavorable impact on both OS (HR: 1.53, 95% CI: 1.29–1.82) and DFS/RFS/DDFS (HR: 1.41, 95% CI: 1.07–1.86) in BC patients. Furthermore, MMP-2 expression was significantly associated with lymph node metastasis (positive vs negative: OR 1.91, 95% CI 1.17–3.12).</p><p>Conclusion</p><p>In conclusion, positive MMP-2 expression might be a significant predictive factor for poor prognosis in patients with BC.</p></div

Forest plots of impact of MMP-2 expression on survival.

<p>HRs with corresponding 95% CIs of MMP-2 expression on (a) OS and (b) DFS/RFS/DDFS.</p

Funnel plots and sensitivity analyses of the meta-analysis.

<p>Funnel plots of the meta-analysis assessing (a) MMP-2 expression and OS (b) MMP-2 expression and RFS/DFS. Sensitivity analyses of the meta-analysis assessing (c) MMP-2 expression and OS (d) MMP-2 expression and DFS/RFS/DDFS.</p

Characteristics of eligible studies for clinicopathological features in meta-analysis.

<p><i>NR</i> not reported, <i>T</i> Tumor cells, <i>S</i> stromal cells, <i>T/S</i> either tumor cells or stromal cells, <i>CS</i> complex score combining intensity and percentage, √ data available for calculating OR and 95%CI.</p><p>Characteristics of eligible studies for clinicopathological features in meta-analysis.</p

Literature search and selection of articles for clinicopathological features.

<p>Literature search and selection of articles for clinicopathological features.</p

Characteristics of eligible studies for survival outcomes in meta-analysis.

<p><i>NR</i> not reported, <i>POSI</i> positive, <i>T</i> tumor cells, <i>S</i> stromal cells, <i>CS</i> complex score combining intensity and percentage, <i>HR</i> HR reported in text, <i>A</i> HR available data or Kaplan—Meier curves, <i>U</i> univariate model, <i>M</i> multivariate model.</p><p>Characteristics of eligible studies for survival outcomes in meta-analysis.</p

Funnel plots of impact of MMP-2 expression on OS with Trim and Fill method.

<p>Funnel plots of impact of MMP-2 expression on OS with Trim and Fill method.</p

Prognostic Role of BRAF Mutation in Stage II/III Colorectal Cancer Receiving Curative Resection and Adjuvant Chemotherapy: A Meta-Analysis Based on Randomized Clinical Trials - Fig 2

<p>Funnel plots for publication bias of OS (a) and DFS (b) meta-analysis: no evidence of bias was found.</p

Sensitivity analysis by omitting each of the included studies in different outcomes.

<p>Sensitivity analysis by omitting each of the included studies in different outcomes.</p

Serum zinc concentration and deficiency prevalence of children¹.

1<p>The results were expressed as mean±SD.</p