title: Impact of elective resection on plasma TIMP-1 levels in patients with colon cancer.
abstract: OBJECTIVE
  Pre- and post-operative plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) levels have a prognostic impact on patients with colorectal cancer. However, the surgical trauma may play an essential role in regulation of plasma TIMP-1 levels, which in turn may influence subsequent TIMP-1 measurements.
  
  
  METHODS
  Consecutively, 48 patients with colon cancer (CC) and 12 patients with nonmalignant colonic disease were randomised to undergo elective laparoscopically assisted or open resection followed by fast track recovery. Plasma samples were collected just before and 1, 2 and 6 h after skin incision, and 1, 2, 8 and 30 days after surgery. TIMP-1 was determined concurrently in all samples by a validated ELISA method.
  
  
  RESULTS
  Geometric mean preoperative TIMP-1 level was 142 ng/ml (range 54-559 ng/ml) among CC patients compared with 106 ng/ml (range 64-167 ng/ml) among patients with nonmalignant diseases (P<0.0001). TIMP-1 levels were decreased significantly 2 h after skin incision compared to the preoperative levels returning to preoperative levels at 6 h. A highly significant (P<0.0001) maximum level was observed 1 day after surgery and was decreasing to preoperative levels 30 days after surgery. Patients undergoing laparoscopically assisted or open resection had similar TIMP-1 levels at each time point.
  
  
  CONCLUSIONS
  Major surgery has considerable impact on plasma TIMP-1 levels. Intra- and post-operative changes of plasma TIMP-1 levels are independent of the surgical approach, and resection for CC does not lead to a significant decrease of plasma TIMP-1 levels within 30 days postoperatively.
authors.affiliation: Department of Surgical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark.
authors.forename: J H
authors.initials: JH
authors.lastname: Hammer
authors.forename: L
authors.initials: L
authors.lastname: Basse
authors.forename: M N
authors.initials: MN
authors.lastname: Svendsen
authors.forename: K
authors.initials: K
authors.lastname: Werther
authors.forename: N
authors.initials: N
authors.lastname: Brünner
authors.forename: I J
authors.initials: IJ
authors.lastname: Christensen
authors.forename: H J
authors.initials: HJ
authors.lastname: Nielson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000097:blood* / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D010535:Laparoscopy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*
chemical_list: D019715:Tissue Inhibitor of Metalloproteinase-1