[The utility of metalloproteinases (MMPs) and their inhibitors (TIMPs) in diagnostics of gynecological malignancies]

Metalloproteinases (MMPs) are a family of proteolytic enzymes, involved in the degradation of collagen and other extracellular matrix components. They play a very important role in many physiological processes, i.e. angiogenesis, hemostasis, cyclic changes in the endometrium, wounds healing, as well as in tumor growth and spreading. Already performed studies have shown significant increase in the expression of MMP-2 and MMP-9 in the most common gynecological cancer (cervix, endometrium, ovary) compared to normal tissue and benign lesions. In addition, the MMP-9 concentration correlated with the clinical stage and the presence of distant metastases. Moreover the level of MMP-2 was significantly associated with the degree of malignancy. MMP-7 may be helpful in the diagnosis of ovarian cancer and useful in estimating of lymph node metastasis presence in endometrial cancer. In the detection of cervical cancer it may be useful to evaluate the expression of MMP-11 and MMP-12 (absent in normal cells) and their increase according to the degree of tissue damage. The usefulness of metalloproteinases in the diagnosis of gynecological cancer still requires confirmation test. However, it appears that they will be valuable factors in diagnostic complement, especially in combination with conventional markers, i.e. CA 125, SCCAg or HE-4.