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A recent article in the Annals of Surgical Oncology reports that the combination of three serum markers increases the accuracy of detecting lymph node metastasis in patients diagnosed with non-small cell lung cancer (NSCLC).

Lung cancer is the leading cause of cancer-related deaths in the United States and Europe. The most common type of lung cancer, non-small cell lung cancer (NSCLC), is a malignancy that arises from the tissues of the lung. Under most circumstances, NSCLC is not curable. This has led to a great deal of research regarding screening, diagnosing and treating NSCLC in an attempt to improve patient outcomes. Several protein-based markers have been identified that can be measured in the patient’s blood to help diagnose NSCLC and determine how far the disease has spread.

In this study, 78 patients who underwent surgery for NSCLC had serum levels drawn for analysis of 3 different markers: MMP-9, VEGF, and VEGF-C. Overall, patients with lymph node metastasis had higher serum levels of VEGF, VEGF-C and MMP-9, than those without lymph node metastasis. Individually, VEGF-C was 85% sensitive (ability to detect the cancer) and 68% specific (ability to differentiate between cancer and a benign tumor); VEGF was 80% sensitive, and 59% specific; MMP-9 was found to be 63% sensitive and 75% specific. Further analysis found that when the 3 tests were combined, the sensitivity and specificity was significantly higher than any one individual test.

Researchers concluded that the examination of VEGF, VEGF-C, and MMP-9 in combination more accurately detects lymph node metastasis in NSCLC than single marker tests. Future clinical trials will further evaluate the significance of these and other markers in an attempt to individualize treatment approaches according to individual risks.

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Reference: Tamura M, Oda M, Matsumoto I, et al. The Combination Assay with Circulating Vascular Endothelial Growth Factor (VEGF)-C, Matrix Mealloproteinase-9, and VEGF for Diagnosing Lymph Node Metastasis in Patients With Non-Small Cell Lung Cancer. Annals of Surgical Oncology. 2004; 11: 928-933.

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