Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2023; 15(5): 931-939
Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.931
Diagnostic value of matrix metalloproteinases 2, 7 and 9 in urine for early detection of colorectal cancer
Liu Peng, Xin Zhang, Man-Li Zhang, Tao Jiang, Peng-Jun Zhang
Liu Peng, Xin Zhang, Peng-Jun Zhang, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional Therapy, Peking University Cancer Hospital & Institute, Beijing 100142, China
Man-Li Zhang, Tao Jiang, Division of Medicine Innovation Research, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Peng L, Jiang T and Zhang PJ designed the study; Peng L, Zhang X performed the research; Peng L, Jiang T, Zhang ML and Zhang PJ analyzed the date; Peng L wrote the paper; Jiang T and Zhang PJ revised the manuscript for final submission; Peng L and Zhang X contributed equally to this study; Jiang T and Zhang PJ are the co-corresponding authors.
Supported by the National Key Research and Development Program of China, No. 2020YFC2004604 and 2020YFC2002700.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Peking University Cancer Hospital & Institute.
Informed consent statement: All study participants or their legal guardian provided written informed consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The study participants provided informed consent for data sharing. No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng-Jun Zhang, PhD, Doctor, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional Therapy, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Beijing 100142, China. zhangpj301@126.com
Received: March 13, 2023
Peer-review started: March 13, 2023
First decision: March 28, 2023
Revised: March 29, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 27, 2023
Abstract
BACKGROUND

A noninvasive biomarker with high diagnostic performance is urgently needed for the early diagnosis of colorectal cancer (CRC).

AIM

To evaluate the diagnostic value of matrix metalloproteinases (MMPs) 2, 7 and 9 in urine for CRC.

METHODS

Of 59 healthy controls, 47 patients with colon polyps and 82 patients with CRC were included in this study. Carcinoembryonic antigen (CEA) in serum and MMP2, MMP7, and MMP9 in urine were detected. The combined diagnostic model of the indicators was established by binary logistic regression. The receiver operating characteristic curve (ROC) of the subjects was used to evaluate the independent and combined diagnostic value of the indicators.

RESULTS

The MMP2, MMP7, MMP9, and CEA levels in the CRC group differed significantly from levels in the healthy controls (P < 0.05). The levels of MMP7, MMP9, and CEA also differed significantly between the CRC group and the colon polyps group (P < 0.05). The area under the curve (AUC) distinguishing between the healthy control and the CRC patients using the joint model with CEA, MMP2, MMP7 and MMP9 was 0.977, and the sensitivity and specificity were 95.10% and 91.50%, respectively. For early-stage CRC, the AUC was 0.975, and the sensitivity and specificity were 94.30% and 98.30%, respectively. For advanced stage CRC, the AUC was 0.979, and the sensitivity and specificity were 95.70% and 91.50%, respectively. Using CEA, MMP7 and MMP9 to jointly established a model distinguishing the colorectal polyp group from the CRC group, the AUC was 0.849, and the sensitivity and specificity were 84.10% and 70.20%, respectively. For early-stage CRC, the AUC was 0.818, and the sensitivity and specificity were 76.30% and 72.30%, respectively. For advanced stage CRC, the AUC was 0.875, and the sensitivity and specificity were 81.80% and 72.30%, respectively.

CONCLUSION

MMP2, MMP7 and MMP 9 may exhibit diagnostic value for the early detection of CRC and may serve as auxiliary diagnostic markers for CRC.

Keywords: Colorectal cancer, Early detection, Matrix metalloproteinases, Urine, Biomarker

Core Tip: Colorectal cancer (CRC) is one of the most common cancers. Early diagnosis and early treatment have become the consensus of CRC diagnosis and treatment. Matrix metalloproteinases (MMPs), as a group of zinc-dependent endopeptidases, participate in the degradation of the extracellular matrix and are secreted and activated outside the cell. We aimed to evaluate the MMP2, MMP7 and MMP9 diagnostic value for early detection of CRC.