Brief Article
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World J Gastroenterol. Oct 7, 2010; 16(37): 4697-4703
Published online Oct 7, 2010. doi: 10.3748/wjg.v16.i37.4697
Prospective study of MMP7 serum levels in the diagnosis of cholangiocarcinoma
Kawin Leelawat, Siriluck Narong, Jerasak Wannaprasert, Thawee Ratanashu-ek
Kawin Leelawat, Siriluck Narong, Jerasak Wannaprasert, Thawee Ratanashu-ek, Department of Surgery, Rajavithi Hospital, Bangkok 10400, Thailand
Kawin Leelawat, Jerasak Wannaprasert, Thawee Ratanashu-ek, College of Medicine, Department of Surgery, Rangsit University, Bangkok 10400, Thailand
Author contributions: Leelawat K conceived, designed and coordinated the study and the statistical analysis and drafted the manuscript; Narong S carried out the MMP-7 assays and helped with the statistical analysis; Wannaprasert J and Ratanashu-ek T coordinated the study and helped with the statistical analysis.
Supported by The Thailand Research Fund (RSA52) and Rajavithi Hospital
Correspondence to: Kawin Leelawat, MD, PhD, Department of Surgery, Rajavithi Hospital, Bangkok 10400, Thailand. kawin.leelawat@gmail.com
Telephone: +66-2-3548080 Fax: +66-2-3548080
Received: April 24, 2010
Revised: July 6, 2010
Accepted: July 13, 2010
Published online: October 7, 2010
Abstract

AIM: To determine whether the serum level of matrix metalloproteinase-7 (MMP7) has the potential to diagnosis cholangiocarcinoma from benign biliary tract diseases.

METHODS: This study was performed according to the PRoBE (a prospective-specimen-collection, retrospective-blinded-evaluation) design. A total of 187 patients with obstructive jaundice were consecutively enrolled. After the diagnostic status of these patients was ascertained, their levels of serum MMP7 were assayed and compared with serum carbohydrate antigen 19-9 (CA19-9). This was conducted in a blinded case (cholangiocarcinoma)-control (benign biliary tract disease) setup.

RESULTS: MMP7 and CA19-9 serum levels were significantly elevated in cholangiocarcinoma patients (P < 0.001). The area under the curve (AUC) from a receiver operating characteristic (ROC) curve analysis for the diagnosis of cholangiocarcinoma, using MMP7 was more accurate than CA19-9 (AUC = 0.84, 95% CI: 0.778-0.903 for MMP7 and AUC = 0.79, 95% CI: 0.708-0.868 for CA19-9). The sensitivity and specificity of serum MMP7 (cut-off value of 5.5 ng/mL) was 75% and 78%, respectively, while the sensitivity and specificity of serum CA19-9 (cut-off value of 100 U/mL) was 68% and 87%, respectively.

CONCLUSION: Serum values of MMP7 and CA19-9 appear to be useful biomarkers for differentiating cholangiocarcinoma from benign biliary tract obstructive diseases.

Keywords: Carbohydrate antigen 19-9; Cholangiocarcinoma; Matrix metalloproteinase-7; Sensitivity; Specificity; Tumor marker