{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:55:40Z","timestamp":1772697340539,"version":"3.50.1"},"reference-count":40,"publisher":"American Association for Cancer Research (AACR)","issue":"10","content-domain":{"domain":["aacrjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background: Matrix metalloproteinases (MMP) are important enzymes in the tumor microenvironment associated with progression of cervical intraepithelial neoplasia (CIN) toward squamous cell carcinoma (SCC) of the cervix. However, the role of MMPs in the inflammatory process associated with Chlamydia trachomatis infection concomitant with the carcinogenic process driven by HPV has not yet been addressed. In the present study, we analyzed the state of the MMP-9\u2013RECK axis in cervical carcinogenesis.<\/jats:p>\n               <jats:p>Methods: The levels of MMP-9 and RECK expression were analyzed by immunocytochemistry in liquid-based cytology samples from 136 women with high-grade cervical lesions (CIN2\/CIN3) and cervical SCC diagnosed by LLETZ, and in 196 women without cervical neoplasia or CIN1. Real-time qPCR was performed to analyze expression of MMP-9 and RECK in 15 cervical samples. The presence of HPV-DNA and other genital pathogens was evaluated by PCR.<\/jats:p>\n               <jats:p>Results: We found a higher expression of MMP-9 [OR, 4.2; 95% confidence interval (CI), 2.2\u20137.8] and lower expression of RECK (OR, 0.4; 95% CI, 0.2\u20130.7) in women with CIN2\/CIN3\/SCC when compared with women from the control group (no neoplasia\/CIN1). A statistically significant association was also found between MMP-9\/RECK imbalance and infection by alpha-9 HPV and C. trachomatis. The prevalence of C. trachomatis infection was significantly higher in women with high-grade cervical disease (OR, 3.7; 95% CI, 1.3\u201311.3).<\/jats:p>\n               <jats:p>Conclusions: MMP-9\/RECK imbalance in cervical smears is significantly associated with high-grade cervical diseases and infection by alpha-9 HPV and C. trachomatis.<\/jats:p>\n               <jats:p>Impact: MMP-9\/RECK imbalance during cervical inflammation induced by C. trachomatis might play a role in HPV-mediated cervical carcinogenesis. Cancer Epidemiol Biomarkers Prev; 24(10); 1539\u201347. \u00a92015 AACR.<\/jats:p>","DOI":"10.1158\/1055-9965.epi-15-0420","type":"journal-article","created":{"date-parts":[[2015,8,11]],"date-time":"2015-08-11T01:49:24Z","timestamp":1439257764000},"page":"1539-1547","update-policy":"https:\/\/doi.org\/10.1158\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["MMP-9\/RECK Imbalance: A Mechanism Associated with High-Grade Cervical Lesions and Genital Infection by Human Papillomavirus and <i>Chlamydia trachomatis<\/i>"],"prefix":"10.1158","volume":"24","author":[{"given":"Michelle G.","family":"Discacciati","sequence":"first","affiliation":[{"name":"1Laboratory of Clinical Cytopathology, School of Pharmaceutical Sciences, University of S\u00e3o Paulo (USP), S\u00e3o Paulo, Brazil."}]},{"given":"Fabr\u00edcia","family":"Gimenes","sequence":"additional","affiliation":[{"name":"2Clinical Cytology Laboratory, State University of Maring\u00e1 (UEM), Maring\u00e1, Paran\u00e1, Brazil."}]},{"given":"Paula C.","family":"Pennacchi","sequence":"additional","affiliation":[{"name":"1Laboratory of Clinical Cytopathology, School of Pharmaceutical Sciences, University of S\u00e3o Paulo (USP), S\u00e3o Paulo, Brazil."}]},{"given":"Fernanda","family":"Fai\u00e3o-Flores","sequence":"additional","affiliation":[{"name":"1Laboratory of Clinical Cytopathology, School of Pharmaceutical Sciences, University of S\u00e3o Paulo (USP), S\u00e3o Paulo, Brazil."}]},{"given":"Luiz C.","family":"Zeferino","sequence":"additional","affiliation":[{"name":"3Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil."}]},{"given":"Sophie M.","family":"Derchain","sequence":"additional","affiliation":[{"name":"3Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil."}]},{"given":"J\u00falio C.","family":"Teixeira","sequence":"additional","affiliation":[{"name":"3Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, S\u00e3o Paulo, Brazil."}]},{"given":"Maria C.","family":"Costa","sequence":"additional","affiliation":[{"name":"4School of Medicine, Santa Casa de S\u00e3o Paulo, INCT-HPV at Santa Casa Research Institute, S\u00e3o Paulo, Brazil."}]},{"given":"Marco","family":"Zonta","sequence":"additional","affiliation":[{"name":"5LEMC Laboratory, Discipline of Infectology, UNIFESP; and Department of Pathology, Santo Amaro University, S\u00e3o Paulo, Brazil."}]},{"given":"Lara","family":"Termini","sequence":"additional","affiliation":[{"name":"4School of Medicine, Santa Casa de S\u00e3o Paulo, INCT-HPV at Santa Casa Research Institute, S\u00e3o Paulo, Brazil."}]},{"given":"Enrique","family":"Boccardo","sequence":"additional","affiliation":[{"name":"6Department of Microbiology, Institute of Biomedical Sciences, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]},{"given":"Adhemar","family":"Longatto-Filho","sequence":"additional","affiliation":[{"name":"7Laboratory of Medical Investigation (LIM), Department of Pathology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."},{"name":"8Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal."},{"name":"9ICVS\/3B's\u2013PT Government Associate Laboratory, Braga\/Guimar\u00e3es, Portugal."},{"name":"10Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil."}]},{"given":"Marcia E.L.","family":"Consolaro","sequence":"additional","affiliation":[{"name":"2Clinical Cytology Laboratory, State University of Maring\u00e1 (UEM), Maring\u00e1, Paran\u00e1, Brazil."}]},{"given":"Luisa L.","family":"Villa","sequence":"additional","affiliation":[{"name":"4School of Medicine, Santa Casa de S\u00e3o Paulo, INCT-HPV at Santa Casa Research 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