To evaluate the association between the expression of human macrophage metalloelastase (matrix metalloproteinase-12, MMP-12) with cancer invasion and differentiation of endometrial adenocarcinoma, specimens from endometrial adenocarcinoma (n=61) of diverse stages and histologic types were collected from patients having undergone hysterectomy, and specimens from normal endometrium (n=38) were obtained from patients with benign diseases. The expression of MMP-12 was analyzed immunohistochemically, by Western blot, and RT-PCR. The positive rate of MMP-12 was significantly increased in endometrial adenocarcinoma (81.97%) as compared with that in normal endometrium (13.16%). The results showed that expression of MMP-12 correlated with stage (p=0.022) and grade (p=0.018) of endometrial cancer. MMP-12 immunoreactive proteins were found mainly on the glandular epithelial cells of endometrial adenocarcinoma. The macrophage infiltration detected by CD68 immunohistochemical staining in endometrial adenocarcinoma was also higher than that in normal endometrium. In this study, we show that in addition to macrophages, endometrial adenocarcinoma cells are able to express MMP-12. Increased MMP-12 expression tended to be associated with the extent of adenocarcinoma invasion accompanied by marked macrophage infiltration. Our results suggest that MMP-12 is an important oncogene in high-stage and high-grade endometrial adenocarcinoma.