Clinical Research Of Perioperative Serum VEGF And MMP-9 Levels In Patients With Non-small Cell Lung Cancer

Objective:Angiogenesis is necessary in tumor progression and metastasis. Serum vascular endothelial growth factor(VEGF) and matrix metalloproteinase -9(MMP-9) are important factors in angiogenesis. Elevated levels of VEGF and MMP-9 are reported in lung cancer. This research is to study the perioperative dynamic changes of serum VEGF and MMP-9 levels in non-small cell lung cancer (NSCLC) patients who undergo surgery.Methods :Serum VEGF and MMP-9 levels were determined in 21 patients with NSCLC who were undergoing surgery by ELISA (enzyme linked immunosorbent assay) method before operation and on postoperative day 1,7,14,21,28. At the same time 12 patients with pulmonary benign diseases treated by surgery were studied as the control. Thirty healthy volunteers served to define normal VEGF and MMP-9.Results :1. Preoperative serum VEGF levels(649.20 pg/ml) was significantly higher in the group of patients with NSCLC compared with the benign and healthy group (respectively:140.70 pg/ml and 94.40 pg/ml, P=0.000).2. Serum VEGF levels were elevated after suegery and the peak was observed on postoperative day +14 (1963.6 pg/ml) in NSCLC , the peak was significantly higher than the preoperative level (649.20 pg/ml) (P=0.000). Then the levels dropped, but it was still significantly higher than the preoperative level(P<0.05).3. Preoperative serum MMP-9 level (82.84 ng/ml) was significantly higher in the group of patients with NSCLC compared with the benign and healthy group (respectively:58.98 ng/ml and 42.94 ng/ml, P=0.000).4. Serum MMP-9 levels were elevated soon after surgery and the peak was Observed on postoperative day +1 in NSCLC.Then serum MMP-9 levels dropped. There is no difference between the preoperative and postoperative day +28 (P>0.05), but difference was still between NSCLC and the benign or healthy group on postoperative day +28 (P<0.05).5. Serum VEGF and MMP-9 levels were elevated also in patients with benign diseases, and the peak were both on postoperative day +7. There was no difference between the levels of preperative and postoperative day +28 (P>0.05), and no difference was found from the healthy group (P>0.05).6. Serum VEGF and MMP-9 levels in patients with NSCLC were related significantly (P<0.05). No relations were found between the changed levels of serum VEGF and MMP-9 with serum VEGF (P>0.05).7. Tumor size and the differentiation were related with preoperative serum VEGF leve (P<0.05). Tumor size, TNM stages, lymph node metastasize, the residue invasived and the time of the surgery were related with the change of serum VEGF (P<0.05). No clinical parameters were found related with the level of serum MMP-9 (P>0.05). Conclusions:Preoperative serum VEGF and MMP-9 levels were both significantly higher in the group of patients with NSCLC compared with the benign and healthy group . Perioperative serum VEGF and MMP-9 levels were both significantly elevated in patients with NSCLC(P<0.05). The peak of serum VEGF was found on postoperative day +14, then the level gradually dropped. It was still higher than the preoperative level on postoperative day +28; The peak of serum MMP-9 was found on postoperative day +1, then the levels dropped after the peak. On postoperative day +28, it was not different from the preoperative level. Significantly relation was found between preoperative serum VEGF and MMP-9. Tumor size and the differentiation were related with preoperative serum VEGF level. Tumor size, TNM stages, lymph node metastasize, the residue invasived and the time of the surgery were related with the change of serum VEGF...