Evaluation of heparanase and matrix metalloproteinase-9 in patients with cutaneous malignant melanoma

Elevated heparanase and matrix metalloproteinase (MMP)-9, frequently found in human cancer, is a major cause of degradation of the extracellular matrix (ECM) and basement membrane (BM), thus facilitating tumor cell migration and invasion. Although a lot of work has been done, the role of heparanase and MMP-9 has not been delineated in skin cancer progression. The purpose of this study was to do such an exploration. To investigate the role of heparanase and MMP-9 in cutaneous malignant melanoma (CMM) development, we performed immunohistochemical analysis to detect the alternation of these two factors in paraffin-embedded biopsy specimens of normal skin, junctional nevi and CMM. It is interesting to note that the expression profile of heparanase and MMP-9 was similar. Contrary to negative staining in normal skin, overexpression of heparanase and cytoplasmic MMP-9 was observed in as many as 70% of CMM, whereas only 10% of the junctional nevi exhibited faint staining (P = 0.0005, P = 0.0000). Considering the lymph node (LN) metastasis, the expression of the two factors is significantly higher in LN-positive lesions than that in LN-negative lesions (P = 0.0295, P = 0.0013). Meanwhile, there was positive correlation between the expression of MMP-9 and heparanase (r = 0.689, P = 0.003). The first expression of MMP-9 and heparanase occurs at benign lesions. However, the significantly increased expression in advanced CMM stages, particularly in LN-positive metastasis lesions, might synergistically contribute to degradation of ECM and BM, therefore promoting carcinogenesis and metastasis.