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May 8, 2026Medical Journal of Babylon0 citationsOpen Access

Correlation Between Serum Matrix Metalloproteinase-9 (MMP-9) and Tissue Inhibitor of Metalloproteinase -1 (TIMP-1) Levels and the Clinical Characteristics of Patients with Pleural Effusion

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NJNoor Hatem JumaaRBRayah BabanYHYaser Aamer Eisa Al- Haibi

Key Result

Serum MMP-9 (12.79 vs 7.95 ng/mL) and TIMP-1 (1150.56 vs 665.51 pg/mL) levels were higher in malignant compared to benign pleural effusions, with a strong positive correlation between them (P<0.001).

Key Points

  • The study aims to investigate the correlation between MMP-9 and TIMP-1 levels in order to differentiate between benign and malignant pleural effusions.
  • Conducted a case-control study with 60 malignant and 60 benign pleural effusion patients.
  • Measured serum levels of MMP-9 and TIMP-1 using the ELISA technique.
  • Analyzed the correlation between MMP-9 and TIMP-1 levels in both patient groups.
  • A strong positive correlation between MMP-9 and TIMP-1 was found (P=0.007 for benign, P<0.001 for malignant).
  • Malignant pleural effusion patients had higher MMP-9 levels (12.79 ± 5.15 ng/mL) compared to benign patients (7.95 ± 2.82 ng/mL).
  • TIMP-1 levels were also significantly higher in malignant pleural effusion patients (1150.56 ± 476.79 pg/mL) compared to benign patients (665.51 ± 350.63 pg/mL).

Study Design

Type

Case-Control (n=120)

Multicenter

No

Structured PICO

Do serum MMP-9 and TIMP-1 levels help distinguish between benign and malignant exudative pleural effusions?

P
Population
120 patients with exudative pleural effusion (60 with malignant pleural effusions and 60 with benign pleural effusions) visiting the medical city – Baghdad Hospital
I
Intervention
Measurement of serum matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels using quantitative sandwich ELISA
C
Comparator
Benign versus malignant pleural effusion
O
Outcome
Correlation between MMP-9 and TIMP-1 and differentiation between benign and malignant exudative pleural effusionssurrogate

Serum MMP-9 and TIMP-1 levels are significantly elevated in malignant pleural effusions and may serve as valuable diagnostic markers to differentiate them from benign effusions.

Main Result

p-value: p=<0.001

Abstract

Abstract Background: Clinically, it can be difficult to distinguish between benign and malignant exudative pleural effusion (PE), and in certain cases. MMP-9 contributes to persistent inflammation and is linked to the aggressivity and metastatic potential of tumors. Objectives: The aim of the present study was to determine the correlation between matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 and to distinguish between benign and malignant exudative pleural effusions. Materials and Methods: This is a case-control study comprising 60 patients with malignant PEs and 60 patients with benign PEs who visited the medical city – Baghdad Hospital. All patients were examined and asked about their medical history, and they measured the levels of serum MMP-9 and TIMP-1 in the serum as markers for differentiation between benign and malignant exudative pleural effusion. It was determined by using the quantitative sandwich (ELISA) technique. Results: It was observed that there is a strong positive correlation between MMP-9 and TIMP-1 with P value = 0.007 in Benign PEs and ( P < 0.001) in Malignant PEs. It was found that patients with malignant pleural effusion have greater serum levels of MMP-9 and TIMP-1 than patients with benign pleural effusion with mean ± SD of MMP-9 ng/mL are 12.79 ± 5.15 in MPEs and 7.95 ± 2.82 in BPEs, whether mean ± SD of TIMP-1 pg/mL are 1150.56 ± 476.79 in MPEs and 665.51 ± 350.63 in BPEs. Conclusions: Our results showed that there is a strong positive correlation between MMP-9 and TIMP-1 indicating that as serum MMP-9 levels increase, serum TIMP-1 level also tends to increase significantly. Also, MMP-9 and TIMP-1 might be valuable markers in differentiating benign from malignant pleural effusions.

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Cite This Study

Jumaa et al. (2026) conducted a case-control in Exudative pleural effusion (n=120). Serum MMP-9 and TIMP-1 measurement vs. Benign pleural effusion was evaluated on Correlation between MMP-9 and TIMP-1 and differentiation between benign and malignant pleural effusions (p=<0.001). Serum MMP-9 (12.79 vs 7.95 ng/mL) and TIMP-1 (1150.56 vs 665.51 pg/mL) levels were higher in malignant compared to benign pleural effusions, with a strong positive correlation between them (P<0.001).

synapsesocial.com/papers/69fd7f0dbfa21ec5bbf07734https://doi.org/10.4103/mjbl.mjbl_1171_23
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