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AIM: To evaluate the expression of matrix metalloproteinase9 (MMP-9) and its clinical significance in esophageal squamous cell carcinoma (ESCC).METHODS: The expression of MMP-9 in 208 cases of ESCC was detected by immunohistochemistry (IHC) and its clinical significance in ESCC especially the relationship with the clinicopathological parameters was analyzed.RESULTS: The percentage of positive cases for MMP-9detected by IHC was 49.0%. MMP-9 was mainly expressed in the cytoplasm of cancer cells especially in the invasive front. Only weak expression was detected in the stromal cells and no expression in non-cancerous mucosa. The expression of MMP-9 was positively correlated with poorer differentiation (P = 0.001＜0.01), existence of vessel permeation (P = 0.027＜0.05) and lymph node metastasis (P = 0.027＜0.05).CONCLJSION: The expression of MMP-9 correlates with the cancer cell differentiation, vessel permeation and lymph node metastasis. It may be a novel biomarker for the diagnosis and treatment of ESCC.