Original Article
Modern Pathology (2008) 21, 1130–1138; doi:10.1038/modpathol.2008.102; published online 20 June 2008
Cellular localization of EMMPRIN predicts prognosis of patients with operable lung adenocarcinoma independent from MMP-2 and MMP-9
Wulf Sienel1,7, Bernhard Polzer2,7, Karimah Elshawi2, Michael Lindner3, Alicia Morresi-Hauf4, Christian Vay2,5, Fabian Eder6, Bernward Passlick1 and Christoph A Klein2
- 1Department of Thoracic Surgery, University Hospital Freiburg, Freiburg, Germany
- 2Department of Pathology, Division of Oncogenomics, University of Regensburg, Regensburg, Germany
- 3Department of Surgery, Asklepios Fachkliniken München-Gauting, Gauting, Germany
- 4Department of Pathology, Asklepios Fachkliniken München-Gauting, Gauting, Germany
- 5Department of General, Visceral, and Pediatric Surgery, Heinrich-Heine University and University Hospital, Düsseldorf, Germany
- 6Department of Pathology, University of Regensburg, Regensburg, Germany
Correspondence: Professor CA Klein, MD, Department of Pathology, Division of Oncogenomics, University of Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany. E-mail: christoph.klein@klinik.uni-regensburg.de
7These authors contributed equally to this work and share the first authorship.
Received 14 January 2008; Revised 6 May 2008; Accepted 7 May 2008; Published online 20 June 2008.
Abstract
Extracellular matrix metalloproteinase (MMP) inducer (EMMPRIN, CD147) is a multifunctional protein that has been implicated in cancer invasion and metastasis by the induction of MMPs. To address its role in primary tumors of human non-small-cell lung cancer we assessed whether EMMPRIN expression is associated with the expression of MMP-2 and MMP-9 and with patient survival. Primary tumors of 150 patients (65 adenocarcinomas, 58 squamous cell carcinomas, and 27 of other subtypes) with completely resected lung cancers were stained by immunohistochemistry. We assessed intensity, extent, and cellular localization of EMMPRIN staining and determined MMP-2 and MMP-9 expression. 145 tumors expressed EMMPRIN (strong expression in 61 tumors), which was predominantly localized at the tumor cell membranes in 102 (68%) patients. We could not determine any correlation between EMMPRIN expression and MMP-2 or MMP-9 expression. The prognostic relevance of EMMPRIN was evaluated by Kaplan–Meier and multivariate Cox regression analysis in patients with adenocarcinoma (n=57) and squamous cell carcinoma of the lung (n=56). The median follow-up period was 36.0 months (range 4–156 months). Staining scores for EMMPRIN and MMP-2 and MMP-9 derived from staining intensities and percentages of positive cells did not predict outcome of patients. In contrast, univariate survival analysis demonstrated that membranous localization of EMMPRIN was associated with shortened survival in patients with adenocarcinoma (P=0.03; log-rank test), but not in squamous cell carcinoma. For the former patients, membranous EMMPRIN expression was also an independent predictor of patient survival (P=0.04; Cox regression analysis). The findings point to a role of EMMPRIN for the progression of adenocarcinoma of the lung that is unrelated to its function as inducer of MMPs.
Keywords:
extracellular matrix, matrix metalloproteases, lung cancer, survival analysis, prognosis
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