[HTML][HTML] A pilot study on faecal MMP-9: a new noninvasive diagnostic marker of colorectal cancer

A Annaházi, S Ábrahám, K Farkas, A Rosztóczy… - British journal of …, 2016 - nature.com
A Annaházi, S Ábrahám, K Farkas, A Rosztóczy, O Inczefi, I Földesi, M Szűcs, M Rutka…
British journal of cancer, 2016nature.com
Background: Colorectal cancer (CRC) is one of the leading malignancies worldwide,
therefore cheap noninvasive screening methods are of great importance. Matrix-
metalloproteinase-9 (MMP-9) has a role in the progression of CRC, and its level is elevated
in tumour biopsies. Faecal MMP-9 levels are increased in active ulcerative colitis patients,
but in CRC patients, they have never been measured. We aimed to assess the faecal MMP-
9 levels in patients undergoing total colonoscopy according to endoscopic and histological …
Abstract
Background:
Colorectal cancer (CRC) is one of the leading malignancies worldwide, therefore cheap noninvasive screening methods are of great importance. Matrix-metalloproteinase-9 (MMP-9) has a role in the progression of CRC, and its level is elevated in tumour biopsies. Faecal MMP-9 levels are increased in active ulcerative colitis patients, but in CRC patients, they have never been measured. We aimed to assess the faecal MMP-9 levels in patients undergoing total colonoscopy according to endoscopic and histological diagnosis.
Methods:
One hundred and nine patients provided faecal samples for MMP-9 analysis. A total colonoscopy was performed; suspicious lesions were evaluated by histology. Faecal MMP-9 levels were measured by ELISA.
Results:
The number of patients allocated to different groups were: negative/diverticulosis: 34 (referred to as controls); hyperplastic polyps: 15; adenomas: 32 (22 at high risk); and CRC: 28. Faecal MMP-9 was significantly increased in CRC compared with all other groups (P< 0.001). Faecal MMP-9 was suitable to distinguish CRC patients from controls (sensitivity: 89.3%; specificity: 91.2%). By means of a lower cutoff level, faecal MMP-9 identified high-risk adenomas besides CRC (sensitivity: 76%; specificity: 85.3%). This lower cutoff level screened 59% of high-risk adenomas.
Conclusions:
Faecal MMP-9 may be a promising new noninvasive marker in CRC.
Main
Colorectal cancer (CRC) represents a major cause of morbidity and mortality in Western societies, and the incidence in developing countries is also rapidly growing (Sung et al, 2008; Siegel et al, 2012). In Europe, CRC is the second most frequent type of malignancy among males and females, with an estimated incidence of> 400 000 new cases per year (Ferlay et al, 2013). The high frequency of the disease and the fact that the prognosis correlates well with the stage at diagnosis makes CRC screening extremely important. Colonoscopy is the gold standard for CRC screening by its high sensitivity and specificity but has also disadvantages, such as risk of complications, high costs and lower acceptance by patients as a screening method. Therefore, noninvasive methods are required to identify patients at high risk of CRC where colonoscopy needs to be performed.
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