Diagnostic value of changes in matrix metalloproteinases upon pancreatic diseases

Abstract

The aim of the study was to analyze the changes in the content of tumor necrosis factor (TNFα), matrix metalloproteinases type 2 and type 9 (MMP-2 and -9) and tissue inhibitor of matrix metalloproteinases type 2 (TIMP-2) in the serum of patients with chronic pancreatitis (CP) and pancreatic cancer.
 Materials and methods. 75 patients with CP and pancreatic head cancer were examined. In the blood taken on an empty stomach, the concentrations of TNFα, MMP-2, MMP-9 and TIMP-2 were determined by an enzyme immunoassay. A statistical analysis of the differences in the median concentrations of MMP-2, MMP-9, TNFα, and TIMP-2 in various pancreatic diseases and in control was carried out using the Kraskel-Wallis test, while post-hoc Dunn test with the Holm correction was used for multiple pairwise comparisons. All calculations and visualization of the results were performed in a computer environment for statistical calculations R (packages stats, PMCMR, ggplot2). The differences between the groups were considered statistically significant at values ​​p≤0.05.
 Results. A statistically significant increase in the number of MMP-9 in the blood serum of patients with pancreatic cancer and patients with CP without cystic formations with a duration of CP of 6-15 years was found in comparison with the control group (p=0.008, p=0.044, respectively). There were no statistically significant differences between the noted groups as for the concentration of MMP-2, TNFα. Comparing the groups of CP with the formation of postnecrotic pancreatic cysts and CP without cystic lesions, a significant decrease in the TIMP-2 concentration was found in patients with postnecrotic pancreatic cysts (p=0.024).
 Conclusion. It was stated by our study that CP as an inflammatory pathology of the pancreas is characterized by changes in the concentration of MMP-9 and TIMP-2. The level of MMP-9 can be used as an additional criterion in developing a strategy for the prediction of pancreatic cancer. The study of such indicators as the system of matrix metalloproteinases and their inhibitors on the background of a chronic inflammatory reaction is an actual and clinically significant task.