PMID- 24939159 OWN - NLM STAT- MEDLINE DCOM- 20150622 LR - 20211021 IS - 1432-2218 (Electronic) IS - 0930-2794 (Linking) VI - 28 IP - 12 DP - 2014 Dec TI - Minimally invasive colorectal resection is associated with significantly elevated levels of plasma matrix metalloproteinase 3 (MMP-3) during the first month after surgery which may promote the growth of residual metastases. PG - 3322-8 LID - 10.1007/s00464-014-3612-9 [doi] AB - INTRODUCTION: MMP-3, a member of the matrix metalloproteinase (MMP) family, is involved in the breakdown of the extracellular matrix in tissue remodeling and may also play a role in cancer progression and metastasis. Minimally invasive colorectal resection (MICR) may increase plasma MMP-3 levels directly via surgical trauma or indirectly due to surgery-associated elevations in TNF-alpha and IL1 which are regulators of MMP-3. This study's purpose was to evaluate plasma MMP-3 levels during the first month after MICR for colorectal cancer. METHODS: Patients enrolled in an IRB approved data/plasma bank who underwent elective MICR for CRC. Blood plasma samples had been collected preoperatively, on postoperative day (POD) 1, 3 and at varying postoperative time points and were stored at -80 degrees C. The late samples (POD 7-41) were bundled into 7 day time blocks and considered as single time points. MMP-3 levels were analyzed in duplicate via ELISA and the results reported as mean +/- SD. The paired t test was used for analysis (significance, p < 0.008 after Bonferroni's correction). RESULTS: A total of 73 CRC patients who underwent MICR met the inclusion criteria. The mean PreOp MMP-3 level was 14.9 +/- 7.8 ng/ml (n = 73). Significantly elevated mean plasma levels were noted on POD 1 (21.4 +/- 14.7 ng/ml, n = 73, p < 0.0001), POD 3 (37.9 +/- 21.5 ng/ml, n = 72, p < 0.0001), POD 7-13 (22.0 +/- 13.0 ng/ml, n = 56, p < 0.0001), POD 14-20 (21.9 +/- 10.3 ng/ml, n = 20, p = 0.003), and on POD 21-27 (21.9 +/- 11.43 ng/ml, n = 20, p = 0.002) when compared to PreOp levels. Plasma levels returned to the PreOp baseline at the POD 28-41 time point (n = 16, p = 0.07). CONCLUSION: Plasma MMP-3 levels remained significantly elevated from baseline for 4 weeks after MICR for CRC. The early postoperative increase in MMP-3 levels may be due to the surgery-related acute inflammatory response; the elevation noted during weeks 2-3 may be related to wound healing. Increased MMP-3 levels may promote metastases or the growth of residual cancer. FAU - Shantha Kumara, H M C AU - Shantha Kumara HM AD - Division of Colon and Rectal Surgery, Department of Surgery, St Luke's-Roosevelt Hospital Center, Suite 7B, 425 West, 59th Street, New York, NY, 10019, USA, hmsach_6@yahoo.com. FAU - Gaita, David J AU - Gaita DJ FAU - Miyagaki, Hiromichi AU - Miyagaki H FAU - Yan, Xiaohong AU - Yan X FAU - Herath, Sonali A C AU - Herath SA FAU - Cekic, Vesna AU - Cekic V FAU - Whelan, Richard L AU - Whelan RL LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study DEP - 20140618 PL - Germany TA - Surg Endosc JT - Surgical endoscopy JID - 8806653 RN - 0 (Biomarkers, Tumor) RN - EC 3.4.24.17 (Matrix Metalloproteinase 3) SB - IM MH - Adult MH - Aged MH - Biomarkers, Tumor/*blood MH - Colectomy/*methods MH - Colorectal Neoplasms/blood/pathology/*surgery MH - Female MH - Follow-Up Studies MH - Humans MH - *Laparoscopy MH - Male MH - Matrix Metalloproteinase 3/*blood MH - Middle Aged MH - Neoplasm, Residual/pathology MH - Postoperative Period MH - Prospective Studies MH - Rectum/*surgery MH - Treatment Outcome EDAT- 2014/06/19 06:00 MHDA- 2015/06/24 06:00 CRDT- 2014/06/19 06:00 PHST- 2014/04/01 00:00 [received] PHST- 2014/05/09 00:00 [accepted] PHST- 2014/06/19 06:00 [entrez] PHST- 2014/06/19 06:00 [pubmed] PHST- 2015/06/24 06:00 [medline] AID - 10.1007/s00464-014-3612-9 [doi] PST - ppublish SO - Surg Endosc. 2014 Dec;28(12):3322-8. doi: 10.1007/s00464-014-3612-9. Epub 2014 Jun 18.