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.
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Authors | N G Hurst, D D Stocken, S Wilson, C Keh, M J O Wakelam, T Ismail |
Journal | British journal of cancer
(Br J Cancer)
Vol. 97
Issue 7
Pg. 971-7
(Oct 08 2007)
ISSN: 0007-0920 [Print] England |
PMID | 17912241
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers, Tumor
- Matrix Metalloproteinase 9
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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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