Serum matrix metalloproteinase 9 and colorectal neoplasia: a community-based evaluation of a potential diagnostic test

Sue Wilson, Sarah Damery, Deborah Stocken, George Dowswell, Roger Holder, Stephen Ward, V Redman, MJ Wakelam, Jonathan James, FDR Hobbs, Tariq Ismail

Research output: Contribution to journalArticle

16 Citations (Scopus)


BACKGROUND: A blood test may be a more acceptable routine colorectal cancer (CRC) screening test than faecal occult blood test, flexible sigmoidoscopy or colonoscopy, and could be safer and cheaper. We evaluated the accuracy of a serum matrix metalloproteinase (MMP9) test for CRC in a non-presenting symptomatic population. METHODS: A cohort, aged 50-69 with lower gastrointestinal symptoms, was identified by community-based survey. Accuracy of serum MMP9 was assessed by comparison with colonoscopy. Logistic regression identified predictors of neoplasia and receiver operating characteristic curve analyses determined the cutoff to maximise the sensitivity. RESULTS: Data were available for 748 patients. Overall, 46 cases of neoplasia were identified. Univariate analysis demonstrated that demographic characteristics, behavioural factors, clinical symptoms and raised serum MMP9 concentration were all significantly associated with the presence of neoplasia. Our final logistic regression model had a sensitivity of 79% and specificity of 70%. CONCLUSION: We demonstrated a significant association between serum MMP9 concentration and the presence of neoplasia. Serum MMP9 levels are raised in those with cancer and high-risk adenomas, although MMP9 estimation is likely to have the greatest predictive utility when used as part of a panel of biomarkers. Further work is required to identify biomarkers that are sufficiently accurate for implementing into routine practice. British Journal of Cancer (2012) 106, 1431-1438. doi: 10.1038/bjc.2012.93 Published online 20 March 2012 (C) 2012 Cancer Research UK
Original languageEnglish
Pages (from-to)1431-1438
Number of pages8
JournalBritish Journal of Cancer
Issue number8
Publication statusPublished - 1 Apr 2012


  • risk
  • screening
  • diagnosis
  • serum
  • colorectal cancer
  • matrix metalloproteinase


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