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Elevated serum matrix metalloproteinase 9 (MMP-9) concentration predicts the presence of colorectal neoplasia in symptomatic patients.

Abstract
Early detection of polyps or colorectal carcinoma can reduce colorectal carcinoma-associated deaths. Previous studies have demonstrated raised serum levels of matrix metalloproteinase 9 (sMMP-9) in a range of cancers. The aim of this study was to investigate the role of sMMP-9 levels in identifying colorectal neoplasia. Consenting patients donated a blood sample and were assessed by proforma-led history and physical examination. Samples were analysed for sMMP-9 concentration (enzyme-linked immuno-sorbant assay) and compared to final diagnoses. Logistic regression modelling determined independent factors associated with neoplasia. A total of 365 patients were recruited of whom 300 were analysed, including 46 normal controls. A total of 27 significant adenomas and 63 malignancies were identified. The median sMMP-9 concentration was 443 ng ml(-1) (IQR: 219-782; mean: 546). Patients with neoplasia had significantly elevated sMMP-9 levels (P<0.001). Logistic regression modelling identified elevated log(sMMP-9) as the most significant predictor of neoplasia (chi(2)=38.33, P<0.001). Other significant factors were age, sex, smoking history, abdominal pain and weight loss. The model accurately predicted neoplasia in 77.3% of cases. Sensitivity and specificity were 77.9 and 77.1%. sMMP-9 estimation can accurately stratify patient to low- or high-risk cohorts. Serum sampling is a potential means of avoiding unnecessary colonoscopy and reducing patient anxiety, iatrogenic morbidity and mortality, and cost.
AuthorsN G Hurst, D D Stocken, S Wilson, C Keh, M J O Wakelam, T Ismail
JournalBritish journal of cancer (Br J Cancer) Vol. 97 Issue 7 Pg. 971-7 (Oct 08 2007) ISSN: 0007-0920 [Print] England
PMID17912241 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Biomarkers, Tumor
  • Matrix Metalloproteinase 9
Topics
  • Adenoma (blood, diagnosis)
  • Adult
  • Aged
  • Biomarkers, Tumor (blood)
  • Cohort Studies
  • Colorectal Neoplasms (blood, diagnosis)
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Male
  • Matrix Metalloproteinase 9 (blood)
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Risk Factors
  • Sensitivity and Specificity

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