Objective To analyze the changes in angiopoietin-2(Ang-2)levels before and after microwave ablation(MWA)in patients with high-risk pulmonary nodule and its impact on postoperative recurrence.Method A total of 94 patients with high-risk pulmonary nodules admitted to Guizhou Aerospace Hospital from December 2019 to December 2021 were included and categorized into a recurrence group(n=30)and a non-recurrence group(n=64).Clinical data was compared between the two groups.Pearson correlation analysis was used to analyze the correlation between pre-treatment angiopoietin-2(Ang-2)levels and CT parameters.Logistic regression model,restricted cubic splines,threshold effect analysis,and receiver operating characteristic(ROC)curve were used to analyze the relationship between pre-treatment Ang-2 levels and postoperative recurrence.Kaplan-Meier survival curves were used to analyze the differences in overall survival among patients with different Ang-2 levels.Cox regression model was used to analyze the factors affecting patients'survival.Result Compared to pre-treatment levels within the same group,Ang-2 levels in both groups decreased significantly,with statistically significant differences(P<0.05).Pearson correlation analysis showed that pre-treatment Ang-2 levels were positively correlated with BF,BV,PS,and MTT.Ang-2 level was independently associated with postoperative recurrence.Results of ROC analysis indicated that pre-treatment Ang-2 had certain predictive value for postoperative recurrence(area under the curve=0.789).Restricted cubic spline analysis revealed a nonlinear dose-response relationship between pre-treatment Ang-2 and postoperative recurrence(P<0.05).Threshold effect analysis identified that the inflection point of Ang-2 affecting recurrence as 1905.41 pg/mL.Survival analysis demonstrated that the median overall survival of patients in the Ang-2<1905.41 pg/mL group was longer than that in the Ang-2≥1905.41 pg/mL group(P=0.039).Furthermore,Ang-2≥1905.41 pg/mL was an independent factor affecting patients'survival time.Conclusion The levels of Ang-2 decreased significantly in patients with high-risk pulmonary nodules after MWA,and pre-treatment Ang-2 level has certain predictive value for postoperative recurrence.

Objective To investigate the value of dynamic contrast-enhanced(DCE)-MRI and DWI for the early assessment of curative effects in NSCLC. Methods Forty patients from September 2012 to September 2014 with NSCLC proven by pathology were examined with DCE-MRI and DWI, at one week before the first chemotherapy and one month after treatment. DCE parameters (MER, slope, WR) and ADC values of the tumors were calculated on the workstation. According to the changes of the tumor-size after treatment, all patients were divided into two groups: good response group and poor response group. Pretreatment parameters were compared between the two groups with independent-samples t test, and parameter changes before and after treatment were compared with paired-samples t Test. ROC curve of tumor response characteristic was analyzed. Pearson correlation coefficient was used to study the correlation between post-treatment parameter changes and tumor size reduction. Results Pretreatment ADC, MER and slope value were (1.15 ± 0.09) × 10-3 mm2/s, 1.13 ± 0.28, (3.76 ± 1.27)% in the good response group(15 patients), and were (1.34±0.33)×10-3mm2/s, 0.78±0.16, (2.63±0.58)%in poor response group(25 patients), respectively. There was significant difference between tumors in two groups(t=2.329, 3.152, 4.556,P=0.027, 0.032, 0.009), the lower ADC value and the higher MER/slope value was observed in the good response group. The change rates of ADC after one month treatment in the two groups were (20.43±6.40)%, (2.98±1.65)%(t=3.485,P=0.009), and slope change were (-61.80±19.21)%, (-30.80±11.16)%(t=3.280, P=0.020). Both the rising rate of ADC and decreasing rate of slope value were significant higher in good response group than the poor response group. The ROC curve was used to analyze the change rate of ADC and slope after tumors treatment, the area under the ROC curve in ADC was largest(Az=0.790), the diagnosis efficiency was highest. We found significant positive correlation between ADC, MER, slope change rate and tumor maximum diameter reduction rate after chemotherapy(r=0.637, 0.396, 0.532,P<0.05). Conclusions DCE parameters and ADC values possess important clinical value to evaluate the early effect of chemotherapy in NSCLC. ADC value is more sensitive to early lung cancer response.