Tumor angiogenesis, the case of which could be reflected through MVD of tumor, plays a critical role in the initiation and progression of tumor invasion and metastases. There have been studies reporting that MVD had a greater increase in IPAs compared with NIPAs (Supplemental Table S9, http://links.lww.com/MD/B35). MMPs, especially MMP-9, could mediate tumor angiogenesis through mutual regulation and influence with vascular endothelial growth factor. According to the aforementioned, MVD of PAs may be correlated with MMP-9 expression. However, we found only two studies that investigated the relationship between them. And although our results suggested elevated MVD in MMP-9-positive PAs, there was no statistical significance, indicating that more studies need to be conducted. We also observed that the level of MMP-9 was higher in recurrent patients than that of primary patients, which means that patients with a high level of MMP-9 are likely to have poor prognosis.
The authors are grateful to all the authors of the studies included in the present study and their study participants.
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