Plasma levels and diagnostic utility of MMP-2 and TIMP-2 in the diagnosis of Iraqi women with breast tumor: A comparative study with Ca 15-3

Matrix Metalloproteinases (MMPs) are a family of homologous Ca, Zn-dependent containing endopeptidases that occupy a major role in extracellular matrix degradation and are involved in cancer progression. MMPs activity in vivo is controlled by tissue inhibitors of metalloproteinases (TIMPs). This study was designed to investigate the plasma levels and diagnostic utility of matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of metalloproteinase-2 (TIMP-2) in comparison to cancer antigen 15-3 (CA 15-3) in women with breast tumor. This study was carried out at the Biochemistry Department, College of Medicine, University of Baghdad and Oncology Teaching Hospital/Medical City, during the period from February 2017 until the end of November 2017. Eighty-eight Iraqi women were enrolled in the study; 38 women with breast cancer (BC, Group I), 25 women with benign breast tumor (Group II) who were diagnosed by oncology group and 25 apparently healthy control women. Women with BC were also sub-classified according to their stage of cancer; stage I, stage II, and stage III. Investigations included plasma measurements of MMP-2, TIMP-2 and CA 15-3 levels in all included women by using enzyme-linked immunosorbent assay (ELISA) technique. The plasma levels of TIMP-2 and MMP-2 showed significantly higher than CA 15-3 values of the diagnostic sensitivity, the predictive values of positive and negative test results (PPV, NPV) and the area under the receiver-operating characteristics (ROC) curve (AUC) in early stages of breast cancer (BC). The combined use of the tested parameters with CA 15-3 resulted in the increase in SE, SP and AUC, especially in the combination with TIMP-2 (100%; 96%; 0.985). The study demonstrated the usefulness of the tested parameters in the diagnosis of BC, especially TIMP-2 with CA 15-3 in early stages of BC.