Iranian Journal of Pathology

EZH2 and MMP1 Overexpression in Colorectal Cancer: Correlation with Tumor Aggressiveness and Clinicopathologic Features

Articles in Press

Document Type : Original Research

Authors

Mayada S Farrag 1
Mohamed S Hemeda 2
Ziad Emarah 3
Khaled El Naghy 3
Khaled Abdelwahab 4
Nesrine S Farrag 5
Afaf T Ibrahiem 6

1 Department of Pathology, Faculty of Medicine, Port Said University, Port Said, Egypt

2 Department of Forensic Medicine and Clinical Toxicology, Port Said University, Port Said, Egypt

3 Department of Medical Oncology, Mansoura Oncology Center, Mansoura University, Mansoura, Egypt

4 Department of Surgical Oncology, Mansoura Oncology Center, Mansoura University, Mansoura, Egypt

5 Department of Community Medicine and Public Health, Faculty of Medicine, Port Said University, Port Said, Egypt

6 Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

10.30699/ijp.2025.2067098.3494
Abstract
Background & Objective: One of the most lethal as well as prevalent malignancies across the globe is colorectal cancer (CRC). MMP1, a certain type of matrix metalloproteinase, as well as EZH2, a histone methyltransferase, are gaining attention for their part in metastasis and tumor progression. This research analyses the expression of immunohistochemistry EZH2 and MMP1 in relation to colorectal carcinoma, and how these two proteins correlate with other clinicopathological features.
Methods: An analysis was done retrospectively on 38 cases of colorectal cancer, which were formalin-fixed and paraffin-embedded. MMP1 and EZH2 staining were assessed immunohistochemically and correlated with the tumor’s stage, lymph nodes, clinical stage, and prognosis. Statistical analysis was conducted with SPSS version16.0 and a level of significance of p <0.05.
Results: Markedly increased expression of EZH2 and MMP1 had a notable correlation with advanced T stage (p =0.01 and0.03) along with metastasis to the regional lymph nodes (p =0.027) and clinical stages III or IV (p =0.04 for EZH2 and p =0.023 for MMP1). Although both markers demonstrated a trend for decreased disease-free survival (DFS), neither achieved statistical significance for DFS or overall survival (OS). 
Conclusion: EZH2 and MMP1 overexpression were associated with aggressive clinicopathologic features (higher T stage, nodal involvement, and advanced clinical stage). However, neither marker showed a statistically significant association with overall survival (OS) or disease-free survival (DFS) in this cohort. Larger, adequately powered studies are required to clarify any potential prognostic value.

Keywords

Colorectal cancer, EZH2, MMP1, Tumor aggressiveness, Survival analysis, Immunohistochemistry

Subjects

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Iranian Journal of Pathology

Articles in Press, Accepted Manuscript
Available Online from 25 February 2026

  • Receive Date 26 July 2025
  • Revise Date 29 January 2026
  • Accept Date 29 January 2026

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