title: Plasma TIMP-1-a marker of metastasis in colorectal cancer.
abstract: OBJECTIVE
  To assess a potential role for plasma assay of TIMP-1 and MMP-9 as markers of disease presence and disease stage in colorectal cancer.
  
  
  METHODS
  Plasma concentration of  TIMP-1 and MMP-9 was measured in 41 patients with proven colorectal cancer and in 20 age/sex-matched controls. In the 38 cancer patients who underwent laparotomy, portal plasma samples were collected in addition to peripheral venous samples, to assess whether these might be a more sensitive indicator of disease severity.
  
  
  RESULTS
  In samples taken preoperatively, systemic plasma levels of both TIMP-1 and MMP-9 were significantly elevated in cancer patients compared with controls (P < 0.0001 and P < 0.0001), respectively. Systemic and portal plasma TIMP-1 levels were significantly higher in those with metastatic disease compared with those with localized disease (P=0.0248 and P=0.0382). Elevated levels of TIMP-1 in systemic blood were seen in those with muscle-invading tumours compared with more superficial lesions (P=0.0349). Plasma MMP-9 levels did not correlate with clinicopathological features.
  
  
  CONCLUSIONS
  TIMP-1 and MMP-9 levels were significantly elevated in the plasma of patients with colorectal cancer. Metastatic disease is associated with significantly higher plasma TIMP-1 than is localized disease. Sampling of portal blood is of no additional benefit when measuring MMP-9 enzyme levels in colorectal cancer.
authors.affiliation: University Department of Surgery, Leicester Royal Infirmary, Leicester, UK.
authors.lastname: Simpson
authors.lastname: Hemingway
authors.lastname: Thompson