Clinical Significance of the Measurements of Serum Matrix Metalloproteinase-9 and Its Inhibitor (Tissue Inhibitor of Metalloproteinase-1) in Patients With Pancreatic Cancer Metalloproteinase-9 as an Independent Prognostic Factor

Objective: Pancreatic cancer (PC) is a malignant tumor with high mortality. Aggressive growth and metastases of PC are the result of basement membrane degradation that may be attributed to the action of matrix metalloproteinase-9 (MMP-9). The aim of the study was to determine the diagnostic and prognostic significance of the measurements of serum MMP-9 and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with PC. Methods: The study involved 78 patients with PC, 45 with chronic pancreatitis, and 70 healthy subjects. We assayed the serum concentrations of MMP-9, TIMP-1, and classic tumor markers (carbohydrate antigen 19-9 and carcinoembryonic antigen) and defined the prognostic value and the diagnostic criteria for all the proteins tested. Results: In the patients with PC, the serum levels of MMP-9, TIMP-1, and the tumor markers were higher as compared with those in the patients with chronic pancreatitis and the healthy subjects. The diagnostic sensitivity and the area under the receiver operating characteristic curve for TIMP-1 were higher than for MMP-9 and the tumor markers. The elevated preoperative concentration of MMP-9 was a significant independent prognostic factor for the patients' survival. Conclusions: These findings indicate a potential clinical significance of serum TIMP-1 and MMP-9 measurements in the diagnosis and prognosis of patients with PC, respectively.