Objective To analyze the blood flow characteristics of the supraclavicular lymph nodes metastasis in patients with advanced non-small cell lung cancer by color Doppler ultrasound, these patients were treated with anlotinib as an anti-angiogenic drug, and therefore to provide help for lung cancer patients to evaluate the curative effect of the drug.

Methods From February 2019 to November 2019, clinical data of 31 advanced non-small cell lung cancer patients in the Chest Hospital, Shanghai Jiao Tong University treated with anlotinib were analyzed retrospectively. The two-dimensional color Doppler ultrasonography characteristics of the metastatic lymph nodes on the clavicle before and after two cycles of anlotinib treatment were compared and the correlation was analyzed.

Results The peak systolic velocity (PSV) of supraclavicular lymph node blood flow in patients after the treatment with anlotinib decreased significantly (12.8 cm/s vs 7.5 cm/s), and the difference was statistically significant (P=0.006). Before the treatment, the blood flow classification of supraclavicular lymph nodes in patients with anlotinib was 38.7%, 12.1%, 18.2% and 29.0% in patients with level 3.1% and 41.9% in patients with level 0, and the difference was statistically significant (P=0.029). Before the treatment, 29.0% of the patients had no blood flow distribution in supraclavicular lymph nodes, and 19.4%, 3.2% and 48.4% in central, marginal, and mixed types, respectively. After treatment with anlotinib the proportion of mixed blood flow pattern in supraclavicular lymph nodes decreased to 22.6%(P=0.001) and that of non-blood flow pattern increased to 41.9%.

Conclusion As an antiangiogenic drug, anlotinib has a direct and effective effect on the blood flow of metastatic supraclavicular lymph nodes. The changes of the size and blood flow characteristics of supraclavicular lymph nodes can be used as a criterion for the short-term efficacy of ultrasound in the diagnosis of lung cancer.