A Meta Analysis Of The Expression And Clinical Significance Of Matrix Metalloproteinase-9 And TIMP-1 In Pancreatic Cancer

purpose:The purpose of this study is to systematically evaluate the expression of MMP-9 and TIMP-1in pancreatic cancer,and their correlation with the biological behaviors of pancreatic cancer such as occurrence and metastasis.method:The self built databases of pancreatic cancer,matrix metalloproteinase-9,gelatinase B,TIMP-1 and free words were searched in China How Net,Wan fang,VIP,baidu academic,PubMed,MEDLINE,Springer Link and EMBASE databases to search all published literatures in February 2020,and the literatures were screened according to inclusion and exclusion criteria.A total of 19 literatures were included,and the corresponding data were extracted.Review Manager5.2 software was used for meta-analysis,or,95%CI and p-value analysis.The expression of MMP-9 / TIMP-1 and the relationship between MMP-9/TIMP-1 and gender,tumor size,differentiation,invasion,TNM stage,lymph node metastasis,distant metastasis and vascular invasion were analyzed.The fixed effect model or random effect model was selected according to the heterogeneity.Stata16 was used for publication bias analysis.result:A total of 19 articles were included,16 of which compared the expression of MMP-9 in pancreatic cancer tissues and normal tissues.The results showed that the expression of MMP-9 in pancreatic cancer tissues was significantly higher than that of normal pancreatic tissues(P<0.00001);The relationship between MMP-9 expression and gender in tissues showed that in pancreatic cancer tissues,there was no significant correlation between MMP-9 expression and gender,and the difference was not statistically significant(P=0.05);The expression of MMP-9was positively correlated with tumor size,(P<0.00001),degree of invasion(P=0.0003),vascular invasion(P=0.0002),TNM stage(P<0.00001),lymphatic metastasis(P<0.00001),distant metastasis(P<0.00001)were all positively correlated,Negatively correlated with the degree of tumor differentiation(P<0.00001),the differences were statistically significant.MMP-9 promotes tumor growth and metastasis,and the higher the expression level of MMP-9,the lower the degree of tumor differentiation and the higher the degree of malignancy.TIMP-1 also increasedcorrespondingly in pancreatic cancer(P=0.008),which had no significant correlation with the degree of tumor differentiation(P=0.15),but negatively correlated with tumor lymphatic metastasis(P=0.0001),TIMP-1 High expression can reduce lymphatic metastasis of tumor.Conclusion:MMP-9 protein is positively correlated with tumor genesis and metastasis in patients with pancreatic caner.In poorly differentiated and undifferentiated tumors,the expression of MMP-9 is significantly increased and its over expression was positively correlated with clinical TNM stage.In pancreatic cancer,there is no difference in the expression of MMP-9 between men and women.TIMP-1 is an inhibitor of MMP-9,which is also highly expressed in pancreatic cancer.Moreover,the TIMP-1 expression is much higher in patients with lymph node meta stasis compared to those without lymph node metastasis,Our data indicates that the up regulation of TIMP-1 suppresses tumor metastasis by inhibiting the activity of MMP-9 protein expression.