The immunoexpression of matrix metalloproteinase MMP2 and MMP9 as prognostic significance in cutaneous metastases of breast carcinoma

Aim. Many types of cutaneous metastasis occur in carcinoma of the breast. Cutaneous metastasis has been reported as having a poor prognosis. A fundamental prerequisite for carcinoma cells to metastatize is the ability of the tumour cells to dissociate from the primary tumour and to breach matrix proteins. Degradation and remodelling of matrix proteins can be affected by a variety of enzymatic activities including the matrix metalloproteinases (MMPs). We have analysed the sensitivity, specificity and predictive value of immunohistochemical staining with monoclonal antibodies directed against gelatinase A (MMP-2) and B (MMP-9) in cutaneous metastatic breast carcinoma. Methods. Twenty-two patients were enrolled. The study included all of the female patients with nodular cutaneous metastasis of breast carcinoma seen between 1997 and 2002 in our Dermatology Department. Two biopsies per patient were taken from lesional skin. Expression of MMP-2 and MMP-9 was investigated by immunohistochemistry. The analysis of survival time was performed by applying the Kaplan-Meier method. Results. The immunoreactivity for MMP-2 and MMP-9 was highly expressed in the neoplastic cells of the group of patients with lower survival time. The survival time of patients with higher MMP-9 and MMP-2 expressions was significantly shorter as compared to those showing low MMP-9 and MMP-2 expression. The survival analysis, performed by applying the Kaplan-Meier method, revealed a significant difference between the survival time of patients in groups with high or low expression of MMP-2 and MMP-9 in neoplastic cells. Conclusion. Immunohistochemical evaluation is a potentially important tool for measuring tumour progression, as well as an improved approach in the biology of the metastatic process. In fact, both the intensity of the immunoreactivity and the percentage of positive tumour cells were associated with the survival time of the patients.