Purpose: Matrix metalloproteinase-7, reversion-inducing cysteine-rich protein with Kazal motifs, chemokine receptor 7, and vascular endothelial growth factor-C have been correlated with tumor invasion and lymph node metastasis in patients with gastrointestinal cancer. Our study of patients with colorectal cancer quantified the messenger ribonucleic acid (RNA) expressions at the deepest site of tumor invasion (the invasive front) and the tumor's inner surface. We investigated whether messenger RNA expressions can predict lymph node metastasis in colorectal cancer tumors and then evaluated the clinical implications of these results on the endoscopic treatment of early colorectal cancer.
Methods: Sixty patients with colorectal cancer participated in the study. Levels of matrix metalloproteinase-7, reversion-inducing cysteine-rich protein with Kazal motifs, chemokine receptor 7, and vascular endothelial growth factor-C messenger RNA in both the invasive front and inner surface of colorectal cancer tumors were measured by using real-time quantitative reverse transcriptase-polymerase chain reaction.
Results: The matrix metalloproteinase-7 values in the invasive front and inner surface were significantly higher in tumors with lymph node metastasis than in tumors without lymph node metastasis. The matrix metalloproteinase-7 expression levels in the invasive front correlated with inner surface expression levels. Both a univariate and multiple logistic regression analysis showed the matrix metalloproteinase-7 expression levels in both the invasive front and inner surface of tumors to be significantly associated with lymph node metastasis.
Conclusions: Matrix metalloproteinase-7 messenger RNA in both the invasive front and inner surface of the tumor is a predictive factor associated with lymph node metastasis for patients with colorectal cancer. The results of this study might indicate further clinical applications of an endoscopic excision for cancer with submucosal invasion.