Prediction and analysis of early recurrence and metastasis in elderly patients with early-stage non-small cell lung cancer after thoracoscopic resection using serum Ang-2 and HIF-1α
FU Ying
ZHANG Jianhui
ZHENG Tian
ZHANG Yun
Abstract：Objective To investigate the predictive value of serum angiopoietin-2(Ang-2)and hypoxia-inducible factor-1α(HIF-1α)for early recurrence and metastasis in elderly patients with stage Ⅰ-ⅡA non-small cell lung cancer(NSCLC)after thoracoscopic resection.Methods A total of 258 elderly patients with stage Ⅰ-ⅡA NSCLC who underwent uniportal video-assisted thoracoscopic surgery at Yuncheng Central Hospital Affiliated to Shanxi Medical University from April 2022 to April 2023 were included.Serum levels of Ang-2 and HIF-1α were measured preoperatively in all patients.They were followed up for 2 years postoperatively and were divided into groups based on the occurrence of recurrence and metastasis during follow-up.Differences in serum Ang-2,HIF-1α levels,and baseline characteristics were compared between the groups.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of serum Ang-2 and HIF-1α levels for postoperative recurrence and metastasis risk.Results All 258 patients completed follow-up(range:7-24 months).Postoperative recurrence and metastasis occurred in 45 patients(17.44％),with a median recurrence time of 16 months.Compared with the non-recurrence group,the recurrence/metastasis group had a higher proportion of stage ⅡA disease and poorly differentiated tumors,and significantly higher preoperative levels of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),Ang-2,and HIF-1α(P＜0.05).Correlation analysis showed a positive correlation between the risk of postoperative recurrence/metastasis and serum levels of Ang-2 and HIF-1α(P＜0.05).ROC curve analysis revealed that the areas under the curve(AUC)for predicting early postoperative recurrence risk using serum Ang-2 alone,HIF-1α alone,and their combination were 0.849(95％CI:0.778-0.920),0.851(95％CI:0.788-0.914),and 0.917(95％CI:0.876-0.959),respectively.The predictive performance of the combined detection was significantly superior to that of either single indicator(Z=1.702,1.724;P=0.044,0.042).Conclusion Serum levels of Ang-2 and HIF-1α are positively correlated with postoperative recurrence and metastasis in elderly patients with stage I-ⅡANSCLC.Combined detection of these two indicators provides a good prediction of postoperative recurrence and metastasis risk.
Keywords：non-small cell lung cancerelderlyangiopoietin-2hypoxia inducible factor-1αrecurrence and metastasisprediction
Publication Date：2026-02-28
Online Publishing Date：2026-04-01(First online date of this platform, not the publication date of the document)
Pages：6( 181-186 )