Lower Serum Matrix Metalloproteinase‑9 in Metastatic Patients with Esophageal Squamous Cell Carcinoma After Concurrent Radiotherapy Was Significant for Prognosis

Figures & data

Figure 1 Boxplots of serum MMP-9 in healthy controls and patients before treatment and after treatment. (A) The median value of MMP-9 concentration in healthy controls and patients before treatment. (B) The median value of MMP-9 concentration between Chemo group and Chemo+Radio group in ESCC patients before treatment and after treatment, respectively. Chemo: patients received at least four times of chemotherapy. Chemo+Radio: patients received concurrent radiotherapy at the first cycle of chemotherapy.

Abbreviation: FC, fold change.

Table 1 Relation of Serum MMP9 to Clinicopathological Characteristics of 207 Postoperative Patients with ESCC (Concentration Unit: Ng/mL)

Group		N	Mean (SD)	Statistic	P value
Gender	Male	179	1060.58 (976.02)
	Female	28	1052.04 (681.07)	0.045	0.964
Age (years)	<60	95	1055.51 (695.14)
	60–70	92	1084.27 (1194.31)
	>70	20	963.70 (590.57)	0.135	0.873
Stage	II	34	1029.65 (727.22)
	III	62	1048.52 (749.53)
	IV	111	1074.63 (1088.40)	0.035	0.965
Differentiation	High	9	1099.78 (915.82)
	Moderate	93	1027.45 (699.33)
	Low	105	1084.28 (1118.96)	0.098	0.907
Metastasis	Yes	164	1109.84 (1016.91)
	No	43	867.14 (523.87)	1.511	0.132

Notes: 207 Postoperative patients received R0 resection. Stage: pathological stage. Metastasis: distant or lymph node metastasis.

Figure 2 Boxplots of serum MMP-9 in ESCC patients with metastasis and non-metastasis. (A) The median value of MMP-9 concentration between metastatic and non-metastatic patients before treatment and after treatment, respectively. (B) The median value of MMP-9 concentration between Chemo group and Chemo+Radio group in ESCC patients with non-metastasis and metastasis respectively after treatment. Chemo: patients received at least four times of chemotherapy. Chemo+Radio: patients received concurrent radiotherapy at the first cycle of chemotherapy.

Abbreviation: FC, fold change.

Figure 3 Mean change in (A) treatment modality, (B) metastasis or (C) survival time relative to the pre-treatment value. The fold change (FC) between post-treatment values and pre-treatment values are calculated and the mean fold decrease was plotted at four different time intervals (the first, second, third and fourth cycles of treatment). Chemo: patients received at least four times of chemotherapy. Chemo+Radio: patients received concurrent radiotherapy at the first cycle of chemotherapy. Metastasis: ESCC patients with metastasis. Nonmetatasis: ESCC patients with non-metastasis.

Figure 4 Boxplots of serum MMP-9 from pre-therapy (0 cycle) and the first, second, third and fourth cycles of post therapy (1, 2, 3, 4 cycles) in (A) 207 ESCC patients and (B) 164 ESCC patients with metastasis. Chemo: patients received at least four times of chemotherapy. Chemo+Radio: patients received concurrent radiotherapy at the first cycle of chemotherapy.

Table 2 The Overall Survival Time of 207 Patients with ESCC After Chemotherapy or Concurrent Radiotherapy

Variables	Overall Survival Time (OS, Months)	Patients (N)
		Total (N)	Chemo Group (%, N=134)	Chemo+Radio Group (%, N=73)
Survival		69	26.9% (36/134)	45.2% (33/73)
	OS <60	7	3.0% (4/134)	4.1% (3/73)
	OS ≥60	62	23.9% (32/134)	41.1% (30/73)
Death		109	59.0% (79/134)	41.1 (30/73)
	OS <12	12	6.7% (9/134)	4.1% (3/73)
	12 ≤ OS < 24	48	28.4% (38/134)	13.7% (10/73)
	24 ≤OS < 36	20	9.0% (12/134)	11.0% (8/73)
	36 ≤ OS < 48	10	4.5% (6/134)	5.5% (4/73)
	48 ≤ OS < 60	9	5.2% (7/134)	2.7% (2/73)
	OS ≥60	10	5.2% (7/134)	4.1% (3/73)
Missing		29

Notes: The follow-up time is as of April 25, 2020. Chemo: patients received at least four times of chemotherapy. Chemo+Radio: patients received concurrent radiotherapy at the first cycle of chemotherapy.

Figure 5 The prognosis values of serum MMP-9 in patients with ESCC. (A) Overall survival with high (≥ 926.49 ng/mL) and low (< 926.49 ng/mL) MMP-9 levels in patients before treatment. Hazard ratio =1.490 (95% CI, 0.995–2.231), P=0.053. (B) Overall survival with Chemo group and Chemo+Radio group. Hazard ratio =1.453 (95% CI, 0.947–2.227), P=0.087. (C) Overall survival with high (≥ 820.693 ng/mL) and low (< 820.693 ng/mL) MMP-9 levels in patients after chemotherapy or concurrent radiotherapy. Hazard ratio =0.155 (95% CI, 0.095–2.254), P < 0.001. Chemo: patients received at least four times of chemotherapy. Chemo+Radio: patients received concurrent radiotherapy at the first cycle of chemotherapy.

Abbreviation: CI, confidence interval.