Peripheral blood expression of matrix metalloproteinases -2, -9 and tissue inhibitor of matrix metalloproteinase -2 as molecular markers for diagnosis and staging of bladder cancer in Egypt.

Some of the best suggested biological markers in bladder cancer are the MMPs, which promote invasion, immune escape and metastasis. We investigated the expression of MMP-2, -9 and TIMP-2 in peripheral blood cells of BC patients to evaluate their role in diagnosis and molecular staging of the disease. Total RNA was extracted from circulating blood cells in 70 subjects (35 healthy controls, 35 patients with bladder cancer in different stages) and expression of MMP-9, MMP-2 and TIMP-2 by real-time RT-PCR was performed. Our results revealed that the relative expression levels of MMP-2 and MMP-9 in BC patients were higher and TIMP-2 was lower than matched controls. The sensitivity of MMP-2, MMP-9 and TIMP-2 in diagnosis of BC was 94.29%, 77.14% and 82.86% respectively. Combining of MMP-2 and MMP-9 resulted in improving the sensitivity. There were increasing trends of the relative expression of MMP-2 and MMP-9 with advancement of grades and stages. In conclusion the single bladder cancer diagnostics marker with the highest sensitivity is MMP-2 and the best two markers combination is MMP-2 and MMP-9. The MMP-2 expression level is the best molecular marker in bladder cancer grading and staging. TIMP-2 is an indicator of advanced BC grade and/ or stage.