Diagnostic and Prognostic Accuracy of MMPs and TIMPs in Oral Cancer Patients on Enzyme-Linked Immunosorbent Assay (ELISA) as Compared to Immunohistochemistry (IHC).

Abstract

Oral cancer is one of most common noncommunicable diseases that imposed significant burden on healthcare around the globe including India. Several molecular markers have been extensively researched for their potential as diagnostic and prognostic biomarkers for oral cancer. Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) found to play a crucial role in cytoskeleton dynamics and thus tumor growth and metastasis. The present study aims to analyze the MMP (MMP-1, MMP-3, MMP-9, and MMP-13) and TIMP (TIMP-1 and TIMP-3) expression in the oral cancer patients as compared to healthy controls. We also aim to compare the diagnostic accuracy of MMPs and TIMPs on enzyme-linked immunosorbent assay (ELISA) with respect to the immunohistochemistry (IHC). A total of 15 oral cancer patients and 14 healthy controls were enrolled in this study. Blood sample from oral cancer patients and healthy controls was obtained to analyze the MMP and TIMP expression levels in serum sample using ELISA. Tumor tissue sample from patients for IHC analysis was obtained by biopsy under local anesthesia. Data were compared between ELISA and IHC for sensitivity and specificity analysis. The mean age of the patients was 47.07 ± 15.74 years with the highest incidence of disease found in male gender (86.7%). MMPs and TIMPs exhibited higher expression in oral cancer patients as compared to healthy controls and the difference was statistically significant in case of MMP-13. MMPs and TIMPs showed stronger expression at advanced stages of cancer on IHC with MMP-9 exhibiting the highest expression level. The highest sensitivity and specificity on ELISA with respect to IHC were exhibited by the MMP-3 followed by MMP-13, TIMP-1, TIMP-3, and MMP-1. MMP-3 and MMP-13 were found to be reliable in terms of diagnostic marker for oral cancer as they found to have the highest sensitivity and specificity on ELISA with respect to IHC. MMP-9 was found to be reliable as a prognostic marker as it expresses highest on IHC at advanced stages of oral cancer.