Lipocalin-2 and matrix metalloproteinase-9 expression in high-grade endometrial cancer and their prognostic value

Histopathology. 2015 Aug;67(2):206-15. doi: 10.1111/his.12633. Epub 2015 Feb 16.

Abstract

Aims: To demonstrate lipocalin-2 (LCN-2) immunohistochemical expression together with matrix metalloproteinase-9 (MMP-9) protein in high-grade endometrial cancer and determine their correlations with FIGO (International Federation of Gynecology and Obstetrics) stage, histological subtype, presence of vascular invasion, patient age and overall and disease-free survival.

Methods and results: Immunohistochemical staining was performed using LCN-2 and MMP-9 antibodies on high-grade endometrial cancer (n = 85) diagnosed at Split University Hospital Centre during 1998-2010. Immunohistochemical expression was determined on archived paraffin-embedded samples and scored semiquantitatively. Survival time was analysed using the Kaplan-Meier method, and the log-rank test was used to assess between-group differences. The Cox proportional hazard regression model was used on multivariate survival analysis. Patients were followed from the time of primary surgery until death or last follow-up until December 2012. LCN-2 and MMP-9 were highly expressed in high-grade endometrial cancer. Univariate analysis showed positive immunohistochemical staining for LCN-2 and MMP-9 to be associated with shorter survival in patients with high-grade endometrial cancer. Multivariate analysis showed LCN-2 overexpression to be associated with shorter overall and disease-free survival in high-grade endometrial cancer.

Conclusions: Our findings suggest that LCN-2 expression may be an important independent indicator of shorter survival in patients with high-grade endometrial cancer.

Keywords: endometrial cancer; lipocalin-2; matrix metalloproteinase-9; survival.

MeSH terms

  • Acute-Phase Proteins / metabolism*
  • Age Factors
  • Aged
  • Disease-Free Survival
  • Endometrial Neoplasms / metabolism*
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Female
  • Gene Expression / physiology*
  • Humans
  • Hysterectomy
  • Immunoenzyme Techniques
  • Lipocalin-2
  • Lipocalins / metabolism*
  • Matrix Metalloproteinase 9 / metabolism*
  • Neoplasm Grading
  • Prognosis
  • Proportional Hazards Models
  • Proto-Oncogene Proteins / metabolism*
  • Retrospective Studies
  • Survival Rate

Substances

  • Acute-Phase Proteins
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Proto-Oncogene Proteins
  • MMP9 protein, human
  • Matrix Metalloproteinase 9