Study Type – Therapy (case series)
Level of Evidence 4
What’s known on the subject? and What does the study add?
Recent data suggest that MMP‐7 is critically involved in metastasis formation. In accordance, we formerly found significantly elevated MMP‐7 tissue expression and serum concentration in samples of patients with metastatic bladder cancer and observed an independent correlation between MMP‐7 levels and patients’ prognosis. In the present study we demonstrated that high preoperative urinary MMP‐7 concentrations are associated with metastatic bladder cancer.
OBJECTIVE
• To assess the presence of matrix metalloproteinase (MMP)‐7 in urine samples of patients with bladder cancer and to investigate the correlation between MMP‐7 urine concentration and clinicopathological variables.
PATIENTS AND METHODS
• The presence of MMP‐7 in the urine of patients with bladder cancer was tested in 32 representative cases using immunoprecipitation followed by western blot analysis.
• Urinary MMP‐7 concentration levels were analyzed in 132 patients with bladder cancer and 96 controls using an enzyme‐linked immunosorbent assay.
RESULTS
• MMP‐7 levels did not differ significantly between patients with localized bladder cancer and controls (P= 0.174). On the other hand, we detected a fourfold, significantly elevated MMP‐7 concentration in urine samples of patients with bladder cancer with regional or distant metastasis (P= 0.003).
• Using a threshold value of 6.88 ng/ml, determined by receiver‐operating characteristic curve analysis, a specificity of 82% and a sensitivity of 78% were observed.
• Western blot analysis revealed that the 55‐kDa tissue inhibitor of metalloproteinase 1 complexed MMP‐7 is the dominant form of urinary matrilysin.
CONCLUSIONS
• MMP‐7 is present in detectable amounts in the urine of patients with bladder cancer. Its concentrations are significantly elevated in patients with metastatic disease.
• Determination of urinary matrilysin level could help to detect bladder cancer metastasis, and may therefore provide a more reliable prognosis and influence therapy decisions.