What is the clinical evidence from this study?

Study design: Cohort. Population: Head and neck squamous cell carcinoma (HNSCC) (n=74). Intervention: High pretreatment serum TIMP-1 level vs. Low serum TIMP-1 level. Primary outcome: 5-year cause-specific survival (p=0.034).

May 1, 2005

Tissue Inhibitor of Matrix Metalloproteinase-1 Is Prognostic in Head and Neck Squamous Cell Carcinoma: Comparison of the Circulating and Tissue Immunoreactive Protein

Key Result

High pretreatment serum TIMP-1 levels were associated with significantly lower 5-year cause-specific survival compared to low levels (38% vs 64%, P=0.034) in patients with HNSCC.

Study Design

Type

Cohort (n=74)

Structured PICO

Does high TIMP-1 expression predict worse survival in patients with HNSCC?

Population

74 patients with head and neck squamous cell carcinoma evaluated for pretreatment serum and tissue TIMP-1 levels and followed for up to 5 years.

Exposure

High pretreatment serum levels of TIMP-1 or positive TIMP-1 immunoreactive protein in tumor

Comparator

Low serum TIMP-1 level or negative TIMP-1 tumor expression

Outcome

5-year cause-specific survival and 5-year relapse-free survivalhard clinical

High circulating and tissue TIMP-1 levels are associated with worse 5-year survival and increased relapse in patients with head and neck squamous cell carcinoma.

Main Result

Absolute Event Rate: 38% vs 64%

p-value: p=0.034

Abstract

PURPOSE: Tissue inhibitors of metalloproteinases (TIMP) are capable of inhibiting the matrix metalloproteinases, but they also possess other biological functions. Little is known about the role of TIMP-1 in the progression and spreading of cancer cells among patients with head and neck squamous cell carcinoma (HNSCC). In this study, the pretreatment serum levels of TIMP-1 or the overexpression of TIMP-1 immunoreactive protein in the primary tumor was correlated to the clinical course in patients with HNSCC. EXPERIMENTAL DESIGN: The TIMP-1 immunoreactive protein was studied in 74 cases representing HNSCC. The tissue immunoreactive protein was evaluated from paraffin-embedded tumor sections in 68 cases using immunohistologic staining with a specific antibody, and in 68 cases the pretreatment serum levels of TIMP-1 were quantitatively measured by ELISA assay. The results were compared with the clinicopathologic factors of the disease and the patients' outcome. RESULTS: A positive correlation was found between the size of the primary tumor (T) and the circulating TIMP-1 level (P = 0.021) or the positive immunoreaction of TIMP-1 in tumor (P = 0.039). The 5-year cause-specific survival was significantly lower in patients presenting with a high serum TIMP-1 level than in those with a low level of TIMP-1 (38% versus 64%, P = 0.034). They also had an unfavorable 5-year relapse-free survival rate (37% versus 56%, respectively). Similarly, the expression of TIMP-1 in tumor was prognostic for shortened survival, the 5-year cumulative relapse-free survival being 42% in patients with a TIMP-1-positive tumor versus 75% in cases with a negative tumor (P = 0.035). Tissue TIMP-1 positivity also seemed associated to the cause-specific survival (P = 0.075) and to be connected with later lymph node or hematogenic relapses. CONCLUSIONS: This study shows for the first time that both circulating and tissue TIMP-1 immunoreactive protein predicts the clinical course and dissemination in HNSCC, suggesting that TIMP-1 might be related to both tumor growth and metastasis in HNSCC.

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