Jemds.com Original Research Article J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 6/ Issue 16/ Feb. 23, 2017 Page 1281 CAN LEVELS OF URINARY MATRIX METALLOPROTEINASES (MMPS) ACT AS AN ALTERNATIVE TO GLEASON’S SCORING IN PROSTATIC MALIGNANCIES Sudipta Banerjee 1 , Ranjan K. Dey 2 , Jayanta K. Rout 3 , Amrita Mukherjee 4 , Srabani Biswas 5 , Rupesh Gupta 6 1 Scholar, Department of Biochemistry, RG Kar Medical College, Kolkata, West Bengal. 2 Associate Professor, Department of Urology, RG Kar Medical College, Kolkata, West Bengal. 3 Assistant Professor, Department of Biochemistry, RG Kar Medical College, Kolkata, West Bengal. 4 Assistant Professor, Department of Biochemistry, RG Kar Medical College, Kolkata, West Bengal. 5 Professor, Department of Biochemistry, RG Kar Medical College, Kolkata, West Bengal. 6 Scholar, Department of Urology, RG Kar Medical College, Kolkata, West Bengal. ABSTRACT BACKGROUND Gleason’s grading is an important prognostic parameter for prostatic malignancies. The invasiveness of the procedure coupled with seeding along the biopsy tract has prompted us to explore the scope of a noninvasive procedure in the form of assay of urinary matrix metalloproteinases (MMPs) with their inhibitors. MATERIALS AND METHODS Early morning midstream urine samples from 40 subjects including 28 cases suffering from carcinoma prostate and 12 subjects of prostatic benign conditions as controls were included in this study. ELISA was performed for each of the parameters. Nonparametric tests were employed for statistical evaluation at 95% confidence interval (p<0.05). RESULTS The mean ranks of MMP7 and MMP13 of case group and control group are 23.55, 13.38 vs. 25.71, 8.33 respectively and Mann- Whitney U values are 82.50 and 22.0 between case and control groups (p<0.01 and p<0.001). We did not find any unanimous result in case of different tissue inhibitors (TIMP1 and TIMP2) of MMPs. Significant Spearman’s correlation of Gleason’s score with MMP-7 (ρ=0.573, p=0.001) and MMP-13 (ρ=0.402, p=0.034) in urine was found. However, no significant correlation has been found between free PSA, TIMP-1 and TIMP-2 with Gleason’s score. Using Kruskal Wallis Test, we did not find any significant mean difference in rank of parameters with different Gleason’s score excepting MMP7 (χ 2 =9.259, DF=3 and p=0.026). CONCLUSION Our study suggesting that MMP7 and MMP13 in urine can be considered as an important substance for diagnosing prostate carcinoma as their levels were found to be higher in malignant than in benign cases. KEYWORDS Gleason Score; Metalloproteinases; Prostate Cancer; Prostate-Specific Antigen; Tissue Inhibitor of Metalloproteinases. HOW TO CITE THIS ARTICLE: Banerjee S, Dey RK, Rout JK, et al. Can levels of urinary matrix metalloproteinases (MMPs) act as an alternative to Gleason’s scoring in prostatic malignancies. J. Evolution Med. Dent. Sci. 2017;6(16):1281-1285, DOI: 10.14260/Jemds/2017/278 BACKGROUND Carcinoma prostate has been found to be the fourth most common malignant neoplasm among worldwide male population (1) and the incidence of this carcinoma is up to 20- fold higher in industrialised countries than developing countries. (2,3) An increased understanding of the biology of prostate carcinoma has led to the need for perception of mechanism of proper diagnosis. (4) Biopsy of prostatic tissue is the mainstay of diagnosis and assessment of severity. Gleason’s scoring based on biopsy findings is used to grade the severity. Although it is a gold standard for diagnosis it is a Financial or Other, Competing Interest: None. Submission 12-01-2017, Peer Review 10-02-2017, Acceptance 16-02-2017, Published 23-02-2017. Corresponding Author: Dr. Rupesh Gupta, Department of Urology, RG Kar Medical College, Khudiram Bose Sarani, Kolkata-700004, West Bengal, India. E-mail: drrupesgupta@gmail.com DOI: 10.14260/jemds/2017/278 highly invasive process, hence the search for assay of a noninvasive procedure has prompted us to undertake this study. The Gleason’s grading system, the most commonly used classification scheme for the histological grading of prostate cancer is based on a low magnification microscopic description of the architecture of the cancer. The predominant pattern is given a grade between 1 and 5 which is then added to the second most dominant pattern. Thus, Gleason’s score can be as low as 2 and as high as 10. (5,6) Our present study also aims at finding out if there is any significant correlation between different parameters and Gleason’s score. The matrix metalloproteinase (MMP) family is comprised of critically important extracellular proteases whose activity has been implicated in normal and pathological processes. The MMPs have a potential role in basal membrane and extracellular matrix degradation constantly facilitating tumour invasion and metastasis development. Endogenous tissue inhibitors of matrix metalloproteinase (TIMPs), typically hold MMPs in check, but in cancer the balance tumbles in favour of MMPs, which ultimately spill over from blood to urine. (7)