div dir="ltr">Abstract:
Breast cancer (BC) is the most common form of cancer among women world wide, although mortality rates are declining in some countries, it remains the leading cause of death among women aged 35-55 years.
In Iraq, cancer of the breast is the commonest cancer in females, in 2005 constituted 31% of all other malignancies in women.
Tumor invasion and metastasis development are the primary determinant of patient outcome accordingly; molecules involved in degradation of the stromal connective tissue and basement membrane components are key elements in tumor invasion and metastasis. Proteolytic enzymes execute the breaking down of matrix elements. Among them is Matrix Metalloproteinase -7 (MMP-7) which is a member of the MMPs family. It plays an important role in carcinoma invasion and metastasis through extracellular matrix degradation. Beside this role it is involved in tumor growth itself or in promotion of malignant potential by autocine or paracrine mechanism. Aim of the study To asses the expression of Matrix Metalloproteinase -7 (MMP-7) in breast tumors and correlation with clinicopathological parameters including (age, size of the tumors, histological types, grade, lymph nodes involvement and lymphovascular permeation). Patients, materials and methods
From the period between November 2009 to July 2010all formalin fixed paraffin embedded tissue blocks were retrieved from archived material of Pathology unit of Al- Kadhemia teaching Hospital, Teaching Lab. of Medical City Hospital and Dr.Raji Al-Hadithi private laboratory for the period between 2008- 2010.
Seventy five cases of surgical breast biopsies (31 mastectomy cases and 44 cases of excisional biopsies) include cases of benign lesions (fibrocystic disease, fibroadenoma, atypical ductal hyperplasia, benign phylloide tumor, sclerosing adenosis, lactating adenoma, tubular adenoma, and intra ductal papilloma,) and cases of malignant breast lesions (insitu ductal carcinoma, insitu lobular carcinoma, invasive ductal carcinoma, infiltrative lobular carcinoma, malignant phylloide tumors, mucinous carcinoma) 4 μ thickness paraffin sections were prepared. For each case, one representative section was stained with H and E and other was stained immunohistochemically for MMP-7, The intensity of the immunostaining was evaluated by dividing the staining reaction in 3 groups negative, Weak and strong immunostaining intensity.
Results 1. Cases with highest mean age (43.27 years) show negative MMP-7 immunostaining; while, the lowest mean age (37.41 years) show weak MMP-7 staining. No correlation has been found between MMP-7 and age. (P= 0.496). 2. The largest mean size (4.47 cm) show strong MMP-7immunostaining; while the lowest mean size (3.79 cm) show weak staining, no correlation has been found between MMP-7 and size of tumors(P= 0.053).. 3. Concerning with different breast lesion (benign and malignant) The percentage of cases with strong MMP-7 immunostainig was higher in invasive breast cancer (24%) in comparison to the benign tumors (12%). All cases of carcinoma in situ (14.67%) show strong MMP-7 staining intensity.
Most of the premalignant cases (9.33%) show strong MMP-7 staining A significant correlation has been found between MMP-7 and different breast lesion (benign and malignant). (p- Value = 0.001) 4. Strong MMP-7 immunostaining was seen mainly in grade II invasive breast cancer but there is no significant correlation between MMP-7staining intensity and all grades of breast cancer. (P value = 0.877). 5. Strong MMP-7immunostaining was seen mainly in malignant cases with positive lymph nodes less than four but there is no significant correlation between MMP-7staining intensity and lymph node involvement. (p= 0.764). 6. No significant correlation between MMP-7immunostaining and lymphovascular permeation. (p= 0.106).
Conclusion 1. No significant correlation has been found with following parameters (age, size, grade, lymph node status and lymphovascular permeation) 2. A significant correlation has been found between MMP-7 and different breast lesion including (benign tumors of the breast, premalignant tumor,invasive breast cancer and carcinoma in situ)