Abstract:Objective To investigate the value of serum levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor-binding protein-7 (IGFBP-7), high mobility group protein (HMG) A2, and HMGB1 in evaluating the prognosis of patients with advanced non-small cell lung cancer (NSCLC) treated with microwave ablation combined with gemcitabine plus cisplatin (GP) chemotherapy. Methods A total of 82 patients with advanced NSCLC who received chemotherapy at CangZhou People's Hospital from January 2020 to December 2024 were selected as the lung cancer group, and 70 healthy individuals who underwent health examinations during the same period were selected as the control group. Patients in the lung cancer group received microwave ablation combined with GP chemotherapy. Serum levels of IGF-1, IGFBP-7, HMGA2, and HMGB1 were compared between the control group and the lung cancer group before and after treatment. Based on prognosis, patients in the lung cancer group were divided into a good prognosis group and a poor prognosis group. Multivariate logistic regression analysis was performed to identify factors influencing prognosis, and receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum IGF-1, IGFBP-7, HMGA2, and HMGB1 for the prognosis of microwave ablation combined with GP chemotherapy. Results Before treatment, the levels of IGF-1, HMGA2, and HMGB1 in the lung cancer group were higher than those in the control group, while the IGFBP-7 level was lower (P<0.05). Compared with pre-treatment levels, post-treatment levels of IGF-1, HMGB1, and HMGA2 in the lung cancer group decreased, while the IGFBP-7 level increased (P<0.05). After microwave ablation combined with GP chemotherapy, 58 patients had a good prognosis, and 24 patients had a poor prognosis. Compared with the poor prognosis group, the good prognosis group had lower serum levels of IGF-1 [ (336.86±8.46) μg/L vs (362.04±8.04) μg/L, t=12.437, P<0.01], HMGB1 [ (2.34±0.21) ng/mL vs (3.04±0.43) ng/mL, t=7.608, P<0.01], and HMGA2 [ (1.56±0.13) ng/L vs (2.38±0.98) ng/L, t=4.084, P< 0.01] and a higher serum level of IGFBP-7 [ (36.82 ± 3.77) ng/L vs (25.37 ± 4.15) ng/L, t=12.149, P<0.01]. Multivariate logistic regression analysis showed that high serum levels of IGF- 1, HMGA2, and HMGB1 and a low serum level of IGFBP-7 were independent risk factors for the prognosis of microwave ablation combined with GP chemotherapy (P<0.05). The areas under the curve (AUC) of serum IGF-1, IGFBP-7, HMGA2 and HMGB1 in predicting the prognosis of microwave ablation combined with GP chemotherapy were 0.883, 0.801, 0.865 and 0.875, respectively, and the AUC of combined detection was the largest, which was 0.974. Conclusion Serum levels of IGF-1, IGFBP-7, HMGA2, and HMGB1 can be served as effective biomarkers for prognostic assessment in patients with advanced NSCLC treated with microwave ablation combined with GP chemotherapy.