title: Evaluation of serum matrix metalloproteinase (MMP)-9 to MMP-2 ratio as a biomarker in hepatocellular carcinoma.
abstract: OBJECTIVE
  Serum matrix metalloproteinase (MMP)-9/ MMP-2 ratios are highly associated with alpha-fetoprotein levels in patients with chronic hepatitis B. In this study, we evaluate the clinical usefulness of this ratio as a biomarker in hepatitis B virus-related hepatocellular carcinoma (HCC).
  
  
  METHODS
  Serum samples from 181 chronic hepatitis B patients (52 healthy carriers, 47 chronic hepatitis patients, 50 cirrhosis patients, and 32 HCC patients) were collected. MMP-9/ MMP-2 ratio was determined by zymography. The results were analyzed using the Receiver-Operating Characteristic (ROC) curve.
  
  
  RESULTS
  Serum MMP-9/ MMP-2 ratios in HCC patients were significantly higher than those in healthy carriers, chronic hepatitis patients, and cirrhosis patients (p = 0.004, 0.034, and < 0.001, respectively). The sensitivity and specificity at the optimal cutoff (0.97) were 69.7% and 73.4%, respectively. Significantly higher MMP-9/ MMP-2 ratios were found in advanced, inoperable HCC patients, compared to those in early stage HCC patients (p = 0.005). No significant difference was found for alpha-fetoprotein levels between these two groups (p = 0.312).
  
  
  CONCLUSIONS
  The serum MMP-9/ MMP-2 ratio can be used as an accessory diagnostic marker in hepatitis B virus-related HCC. This ratio is useful in distinguishing between patients with early stage HCC and those with advanced HCC.
authors.affiliation: Liver Research Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Huei-Chung
authors.initials: HC
authors.lastname: Yeh
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Lin
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
authors.forename: Tai-Long
authors.initials: TL
authors.lastname: Pan
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Wang
authors.forename: Chau-Ting
authors.initials: CT
authors.lastname: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000201:enzymology* / Q000821:virology; D002353:Carrier State / Q000201:enzymology / Q000473:pathology / Q000821:virology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000201:enzymology* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000201:enzymology* / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000201:enzymology* / Q000821:virology; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9