Matrix Metalloproteinase 9 for Evaluating Invasiveness and Recurrence in Pituitary Adenoma Patients: A Meta-analysis

Abstract Background: In recent years, matrix metalloproteinase 9 (MMP-9) has been consideredto be an indicator of the aggressiveness and recurrence of pituitary adenomas, especially in China. However, some results have led to many conflicts. Therefore, it is necessary to perform a meta-analysis to obtain a clear correlation between MMP-9 and invasiveness and recurrence. Methods: Eligible studies obtained through multiple searches were included, and the odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were estimated. Funnel plots were used to evaluate publication bias. In the current meta-analysis, 23 articles with a total of 1,213 patients were included, including three studies conducted in Europe and China. Results: High MMP-9 expression and invasiveness of pituitary adenomas (n = 22, OR = 4.75, 95% CI = 3.53-6.39, p<0.05) and tumour recurrence (n = 3, OR = 4.38, 95% CI = 1.76-10.94, p = 0.002) were closely related. In addition, the expression of MMP-9 in patients with functional and non-functional pituitary adenomas was also significantly different (n = 3, OR = 2.07, 95% CI = 1.03-4.16, p = 0.041). Conclusion: MMP-9 is closely related to the invasiveness, functional status and recurrence of pituitary adenoma and should be used as a routine diagnostic index for surgical treatment of pituitary adenoma.