Serum TIMP-1 shows a potential association with metastatic disease in patients with pancreatic cancer: a pilot analysis without a healthy control cohort

Pancreatic ductal adenocarcinoma (PDAC) is most often diagnosed at an advanced stage, when distant metastases are already present and curative treatment options are limited. In this clinical context, biomarkers capable of reflecting tumor aggressiveness and metastatic potential are of particular relevance. Tissue inhibitor of metalloproteinases-1 (TIMP-1) has been implicated in tumor invasion and metastatic dissemination; however, its clinical significance in pancreatic cancer remains incompletely defined. We analyzed TIMP-1 concentrations in serum and pancreatic tissue of 154 patients (108 malignant tumors, 46 benign lesions) using ELISA. Associations with clinical stage and the presence of distant metastases were assessed using non-parametric tests and ROC curve analysis. TIMP-1 levels were significantly higher in malignant compared with benign tumors, both in tissue (24.28 vs. 21.62 ng/mL; p = 0.0318) and serum (28.03 vs. 25.52 ng/mL; p = 0.0106). Serum TIMP-1 showed superior diagnostic accuracy (AUC = 0.796) compared to tissue TIMP-1 (AUC = 0.745). Patients with distant metastases exhibited significantly higher serum TIMP-1 levels than non-metastatic cases (28.33 vs. 26.53 ng/mL; p = 0.0046; AUC = 0.785). Serum TIMP-1 is associated with malignant and metastatic pancreatic disease and reflects a more aggressive tumor phenotype in patients with established pancreatic cancer. While the observed differences are modest and limit its applicability as a stand-alone diagnostic or screening biomarker, TIMP-1 may provide clinically relevant information regarding metastatic status and could contribute to prognostic stratification or multimarker approaches in pancreatic cancer.