Diagnostic valuation of MMP family members as biomarkers for pancreatic cancer: a systematic review and meta-analysis.

BACKGROUND: There are numerous controversies surrounding the diagnosis of matrix metalloproteinases (MMPs) in pancreatic cancer (PC). Consequently, this study conducts the first comprehensive meta-analysis evaluating the diagnostic performance of MMP family members in PC, highlight potential biomarkers, and investigate sources of heterogeneity. METHOD: Articles on the MMP family and PC diagnosis were retrieved from PubMed and Web of Science. Diagnostic accuracy was assessed using sensitivity (SEN) and specificity (SPE). Threshold effects, heterogeneity (via meta-regression and subgroup analyses), and result robustness (via sensitivity analysis) were evaluated. Publication bias was examined using Deeks' funnel plot. RESULT: This meta-analysis included 48 studies from 23 articles, covering 12 types of MMP. The aggregated SEN, SPE, and area under the curve (AUC) for MMPs in diagnosing PC ranged from 0.61 to 0.76, 0.66 to 0.78, and 0.7273 to 0.8840, respectively. Meta-regression identified sample type as a major contributor to heterogeneity, with tissue-based MMPs showing markedly superior diagnostic performance compared to serum or plasma-based assays. Overall, MMPs showed potential diagnostic value, but their accuracy remains moderate and requires further validation in larger, well-designed studies. CONCLUSION: MMPs represent potential candidates for PC diagnosis, but current evidence is insufficient for clinical application, requiring further prospective studies.