RESUMO
The purpose of this work was to evaluate the role of plasma matrix metalloproteinase 1 [MMP1] and tissue inhibitor of metalloproteinase 1 [TIMP1] in diagnosis and staging of prostate cancer patients. This study was conducted on 60 male patients [aged 48-80 years] and 20 age matched healthy individuals. Patients were classified according to clinical examination, prostate specific antigen [PSA] findings, pathological and radiological findings into : 25 patients with benign prostatic hyperplasia [BPH] and 35 patients with different stages of prostate cancer [PC] divided into : [13 PC with no metastasis, 13 PC with local metastasis and 9 PC with distant metastasis]. Plasma MMP1 and TIMP1 were assayed using sandwich immunoassay technique for all subjects. Serum total prostate specific antigen [TPSA] and serum alkaline phosphatase [ALP] were measured to all patients and control group. Free PSA and PSA index were performed for patients with TPSA between 4 and 10 ng/mL. PSA index was found to be superior to TPSA in discriminating patients with prostate cancer [p < 0.001]. There was no significant difference in plasma MMPI levels between different studied groups [p > 0.05]. Serum ALP was significantly increased in PC patients with distant metastasis than those with local metastasis; ALP was additionally found to be the best predictive marker for the presence of distant bone metastasis. Using ROC, Plasma ALP showed a diagnostic sensitivity for bone metastasis in prostate cancer patients of 100% at a cutoff of 90IU/L Median levels of plasma TIMP1 were found to be increased in PC patients [n = 35] over BPH [n = 25] [1600, 180 ug/L respectively]. Additionally, plasma TIMP1 median levels showed a progressive increase with malignant progression of PC being 400 ug/L in PC with no metastasis [n = 13], 2200 ug/L in PC with local metastasis [n = 13] and 4000 ug/L in PC with distant bone metastasis [n = 9], with a statistically significant difference between groups [p < 0.001]. There was a significant negative correlation between TIMP1 and PSA index in PC patients. TIMP1 also correlated positively with ALP in the same group. Mean-while, TIMP1 proved to best discriminate PC patients with metastasis [local and distant] from those with no metastasis. Accordingly, plasma TIMP1 is accurately correlated with staging of prostate cancer and is a promising marker of malignant progression of prostate cancer. Moreover, addition of ALP can effectively detect distant bone metastasis in PC patients