Prognostic Value of miR-21 and miR-486 in Pulmonary Nodule Surgery

Pulmonary nodules pose a significant diagnostic and therapeutic challenge. Clock-guided anatomical positioning is a novel technique that improves the precision of minimally invasive surgical resection. MicroRNAs, such as miR-21 and miR-486, are known to be involved in tumorigenesis and have been identified as potential biomarkers. This study was a prospective cohort study designed to investigate the prognostic significance of miR-21 and miR-486 expression in the context of this advanced surgical technique. A total of 138 patients undergoing clock-guided minimally invasive surgery for pulmonary nodules were enrolled. Intraoperative nodule tissues were collected to quantify miRNA expression levels via real-time PCR. Patients were then stratified into high-expression and low-expression groups based on predetermined cut-off values. Postoperative outcomes, including residual nodule characteristics (size, density, metabolic activity) and survival data (Overall Survival and Progression-Free Survival), were collected and compared between the two groups to assess the predictive power of these miRNAs.

Inclusion criteria

• Age ≥18 years;
• Single or multiple pulmonary nodules confirmed by imaging;
• Pathologically confirmed or highly suspected malignancy;
• Eligible for clock-guided minimally invasive surgery;
• No contraindications to surgery;
• Signed informed consent.

Exclusion criteria

• Uncontrolled comorbidities (e.g., hypertension >180/110 mmHg, HbA1c >9%);
• Inoperable status;
• Benign nodules confirmed by pathology;
• Severe organ dysfunction (e.g., LVEF <40%, eGFR <30 mL/min);
• Immunosuppressive therapy;
• Recent anticancer treatment (<3 months);
• Lost to follow-up.