Clinical Significance of NGAL, MMP-9, and VEGF in Colorectal Cancer Patients

Abstract

Objectives. We aimed to investigate the levels of neutrophil gelatinase associated lipocalin (NGAL), matrix metalloproteinase (MMP-9) and vascular endothelial growth factor (VEGF) among colorectal cancer (CRC) patients especially among pre and post-treated individuals. Materials and methods. A total of 162 CRC patients were enrolled and they were divided according to their clinical stage into early CRC stage (stage I, II, and III, n=90) and advanced stage (stage IV, n=72). A group of healthy individuals (n=57) were also included as controls. Blood samples were collected from them before and after they received treatments as well as from the control group where NGAL, MMP-9, VEGF, CEA and CA19-9 were asses in their sera using Enzyme linked immunosorbent assay. Results. Serum levels of NGAL, MMP-9, their ratio (NGAL/MMP-9) and VEGF were significantly higher in CRC patients as compared with control individuals. By using the receiver operating characteristic (ROC) curve for detection of the diagnostic efficacy, NGAL and MMP-9 were superior to other markers and routine tumor markers (CEA and CA19-9) in detection of CRC patients. Levels of investigated biomarkers in both early and advanced post-treated CRC were significantly decreased than in pretreated patients as compared to CEA and CA19-9 as they did not report significance decrease. Conclusion. Our findings suggest the usefulness of serum NGAL, MMP-9, VEGF in diagnosis of CRC patients and their superiority over CEA and CA19-9 as adjuvant biomarker for treated patients.