Tissue inhibitor of matrix metalloproteinase-1 in the plasma of patients with gastric carcinoma - A possible marker for serosal invasion and metastasis

BACKGROUND. Expression of the tissue inhibitor of matrix metalloproteinase- 1 (TIMP-1) in tumor tissue from patients with gastric carcinoma has been re ported to be related to disease progression. However, to the authors' knowl edge the clinical significance of plasma TIMP-1 concentrations in these pat ients has not been clarified. METHODS. Concentrations of TIMP-1 protein were examined by enzyme-linked im munoadsorbent assay in plasma samples from 149 patients who underwent resec tion of their primary tumors and from 18 patients with nonresected or recur rent disease. RESULTS, In the 149 patients whose primary tumors were resected, plasma TIM P-1 concentration was associated significantly with a variety of pathologic factors including macroscopic type, depth of invasion, lymph node and peri toneal metastases, vessel invasion, pattern of tumor infiltration into surr ounding tissue, and disease stage. Plasma TIMP-1 concentration was signific antly higher in patients with serosal invasion, lymph node metastasis, peri toneal dissemination, or liver metastasis than in those without these facto rs. Neither carcinoembryonic antigen (CEA) nor CA 19-9 concentrations appea red to be related to these measures of disease progression. In the 18 patie nts with nonresected or recurrent disease, TIMP-1, CEA, and CA 19-9 were si milarly sensitive in predicting peritoneal, liver, and lymph node metastase s. The combination of these three factors was able to detect 73.3% of patie nts with peritoneal metastasis, 83.3% of patients with liver metastasis, an d 88.9% of patients with disease recurrence. CONCLUSIONS. In patients with gastric carcinoma, plasma concentration of TI MP-1 appears to correlate with both serosal invasion and metastasis. Cancer 1999;86:1929-35. (C) 1999 American Cancer Society.