title: Angiogenic response to major lung resection for non-small cell lung cancer with video-assisted thoracic surgical and open access.
abstract: BACKGROUND
  Angiogenic factors following oncological surgery is important in tumor recurrence. Vascular endothelial growth factor (VEGF), angiopoietin 1 (Ang-1), Ang-2, soluble VEGF-receptor 1 (sVEGFR1) and sVEGFR2 may influence angiogenesis. This prospective study examined the influence of open and video-assisted thoracic surgery (VATS) lung resections for early stage non-small cell lung cancer (NSCLC) on postoperative circulating angiogenic factors.
  
  
  METHODS
  Forty-three consecutive patients underwent major lung resection through either VATS (n = 23) or Open thoracotomy (n = 20) over an 8-month period. Blood samples were collected preoperatively and postoperatively on days (POD) 1 and 3 for enzyme linked immunosorbent assay determination of angiogenic factors.
  
  
  RESULTS
  Patient demographics were comparable. For all patients undergoing major lung resection, postoperative Ang-1 and sVEGFR2 levels were significantly decreased, while Ang-2 and sVEGFR1 levels markedly increased. No significant peri-operative changes in VEGF levels were observed. Compared with open group, VATS had significantly lower plasma levels of VEGF (VATS 170 ± 93 pg/mL; Open 486 ± 641 pg/mL; P = 0.04) and Ang-2 (VATS 2484 ± 1119 pg/mL; Open 3379 ± 1287 pg/mL; P = 0.026) on POD3.
  
  
  CONCLUSIONS
  Major lung resection for early stage NSCLC leads to a pro-angiogenic status, with increased Ang-2 and decreased Ang-1 productions. VATS is associated with an attenuated angiogenic response with lower circulating VEGF and Ang-2 levels compared with open. Such differences in angiogenic factors may be important in lung cancer biology and recurrence following surgery.
authors.affiliation: Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong. calvinng@surgery.cuhk.edu.hk
authors.forename: Calvin S H
authors.initials: CS
authors.lastname: Ng
authors.forename: Song
authors.initials: S
authors.lastname: Wan
authors.forename: Randolph H L
authors.initials: RH
authors.lastname: Wong
authors.forename: Anthony M H
authors.initials: AM
authors.lastname: Ho
authors.forename: Anthony P C
authors.initials: AP
authors.lastname: Yim
mesh_terms: D000368:Aged; D042683:Angiopoietin-1 / Q000097:blood; D042702:Angiopoietin-2 / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D011446:Prospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000097:blood
chemical_list: C467630:ANGPT1 protein, human; D042683:Angiopoietin-1; D042702:Angiopoietin-2; D015415:Biomarkers; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2