The prognostic role of matrix metalloproteinase 2 in gastric cancer: a systematic review with meta-analysis

The prognostic role of matrix metalloproteinase 2 (MMP-2) in gastric cancer remains controversial. We systematically reviewed the evidence for assessment of MMP-2 expression in gastric cancer to elucidate this issue. Pubmed, Embase and Web of Science were searched to identify eligible studies to evaluate the association of MMP-2 expression and overall survival and clinicopathological features of gastric cancer. MMP-2 overexpression was significantly correlated with poor OS of gastric cancer patients (HR 1.92, 95 % CI 1.48-2.48). Subgroup analysis indicated that MMP-2 overexpression had an unfavorable impact on OS in Asian countries (HR 2.23, 95 % CI 1.57-3.17) and European countries (HR 1.43, 95 % CI 1.13-1.80). Furthermore, MMP-2 overexpression was significantly associated with TNM stage (TIII/TIV vs TI/TII: OR 2.17, 95 % CI 1.64-2.87), the depth of invasion (T3/T4 vs T1/T2: OR 2.59, 95 % CI 1.63-4.12), lymph node metastasis (positive vs negative: OR 2.21, 95 % CI 1.69-2.88), and distant metastasis (positive vs negative: OR 4.44, 95 % CI 1.24-15.94). This meta-analysis indicated that MMP-2 overexpression might be a predictive factor for poor prognosis for gastric cancer.