Key enzymes of the extracellular matrix in colorectal cancer.

The role of extracellular matrix enzymes in the development of distant metastases of colorectal cancer was studied. The expression of types 2 and 9 matrix metalloproteinases was evaluated in primary colorectal adenocarcinomas (264 patients) and their metastases in the lymph nodes (127 patients) and liver (109 patients). Increased expression of matrix metalloproteinase-9 was associated with the probable progress of tumor process and with a low level of histological differentiation of the tumor (p=0.048), deeper invasion of the tumor in the intestinal wall (p=0.012), unfavorable outcome (p=0.037), high risk of metastases in the liver, and worse overall and uneventful survival of patients with colorectal cancer (p=0.001 and p=0.01, respectively). High expression of matrix metalloproteinase-2 was less significant for the invasive potential and prognosis of colorectal tumors. It is suggested that matrix metalloproteinase-9 is an important marker for analysis of the postoperative prognosis and risk of metastases in the liver in patients with colorectal cancer.