非小细胞肺癌胸腔镜与常规开胸术后血清VEGF、MMP-9变化的研究

BACKGROUND AND OBJECTIVE: Vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) are important factors in angiogenesis. These factors function in the angiogenesis of lung cancers. The aim of this study is to determine the changes in serum VEGF and MMP-9 after patients with NSCLC were subjected to lobectomy. The aim of this study is also to compare the differences in the changes observed between video-assisted thoracoscopic surgery (VATS) and traditional open surgery (TOS). METHODS: A total of 43 consecutive patients with NSCLC were recruited from October 2010 to August 2012. All of these patients underwent lobectomy and systematic mediastinal lymphadenectomy. Blood was drawn from these patients to measure the serum levels of VEGF and MMP-9 in the morning before surgery and on postoperative days 1, 2, 3, and 7 (POD1, POD2, POD3, and POD7, respectively). Perioperative variations in serum VEGF and MMP-9 were also observed. Using different surgical options, we divided the patients into two groups: VATS group (25 patients) and TOS group (18 patients). The differences in the changes in serum VEGF and MMP-9 were then compared between the two groups. RESULTS: After surgery, the serum VEGF and MMP-9 of patients with NSCLC initially increased and subsequently decreased. The peak levels were observed on POD2 and POD3, and these levels were significantly higher than the preoperative levels (P=0.031, P=0.020). On POD7, the serum VEGF and MMP-9 remained higher than the preoperative levels. In VATS and TOS groups, the serum VEGF and MMP-9 levels also initially increased and subsequently decreased. The TOS group showed a more evident variation. However, no significant statistical differences in the changes of VEGF and MMP-9 were found between the two groups (F=2.022, P=0.163; F=1.703, P=0.199). CONCLUSION: Serum VEGF and MMP-9 remarkably increase in TOS group and VATS group. Although the serum level of VEGF an MMP-9 in TOS group were higher than that in VATS group. But no significant difference was observed between VATS and TOS group.