Percutaneous microwave ablation (MWA) increased the serum levels of VEGF and MMP-9 in Stage I non-small cell lung cancer (NSCLC)

Int J Hyperthermia. 2017 Jun;33(4):435-439. doi: 10.1080/02656736.2017.1284350. Epub 2017 Feb 2.

Abstract

Background: Lung cancer is the leading cause of cancer death around the world. Percutaneous microwave ablation (MWA) is an emerging treatment strategy for medically inoperable early-stage non-small cell lung cancer (NSCLC). In this study, we investigated the association of MWA and serum angiogensis promoters VEGF and MMP-9 in these patients subgroup.

Methods: We enrolled 52 patients with Stage I NSCLC patients in this study. For each patient, blood samples were drawn by venous puncture, one immediately prior to MWA and the others on Post-Procedure Days (PPD) 1, 3, 5, 7, 10 and 14. Serum samples were analysed for VEGF and MMP-9 levels with use of commercially available enzyme-linked immunosorbent assay. Also, blood samples of 28 healthy volunteers were set as the healthy controls.

Results: We did not observe a significant difference of serum VEGF and MMP-9 between NSCLC patients and healthy controls. The VEGF levels increased on the first day (256.0 ± 6.16 pg/ml, p < 0.05) after MWA and peaked on the PPD3 (418.0 ± 14.54 pg/ml, p < 0.05). Although it gradually reduced afterwards, its levels on PPD14 (141.2 ± 4.41 pg/ml, p < 0.05) was still higher than pre-procedure level. The serum MMP-9 level was significantly elevated from PPD1 (231.3 ± 7.93 ng/ml, p < 0.05) until PPD10 (155.3 ± 5.62 ng/ml, p < 0.05), while it normalised to pre-procedure level on PPD14 (90.78 ± 3.36 ng/ml, p > 0.05). The highest MMP-9 level was observed on PPD5 (399.7 ± 17.70 ng/ml, p < 0.05).

Conclusion: Our preliminary results indicated that percutaneous MWA resulted in increased serum levels of VEGF and MMP-9 in Stage I NSCLC patients. Antiangiogenesis approaches may be helpful for patients defending against metastases during the immediate post-ablation time window.

Keywords: MMP-9; Microwave ablation (MWA); VEGF; non-small cell lung cancer (NSCLC).