贝伐单抗联合化疗对晚期结直肠癌患者循环内皮细胞的影响

目的探讨结直肠癌患者接受贝伐单抗联合化疗前后,外周血循环内皮细胞(CECs)与活性循环内皮细胞(aCECs)的变化及临床意义。方法选取2014年10月至2016年3月间内蒙古自治区人民医院收治的53例晚期肠癌患者为研究对象,另选取同期体检且各项指标正常的志愿者20人为对照。检测晚期结直肠癌患者采用贝伐单抗联合化疗前后与健康20人外周血CECs及aCECs。结果健康人CECs与aCECs明显少于晚期肠癌患者。完成治疗的28例患者中,临床获益(CR+PR)组治疗后CECs和aCECs均较治疗前明显减少,差异均有统计学意义(均P<0.05)。稳定(SD)组治疗前后,CECs变化不明显,差异无统计学意义(P>0.05);aCECs减少,差异有统计学意义(P<0.01)。进展(PD)组CECs和aCECs治疗后与治疗前均变化不大,差异均无统计学意义(均P>0.05)。结论联合检测CECs及aCECs可以预测贝伐单抗联合化疗治疗晚期结直肠癌的疗效。     

重组人血管内皮抑素联合NP方案治疗晚期非小细胞肺癌的临床观察

目的:观察YH-16联合长春瑞滨和顺铂(NP)治疗晚期非小细胞肺癌(NSCLC)的近期疗效和安全性,同时探讨循环血管内皮细胞(CECs)与该方案疗效的相关性.方法:应用YH-16联合NP方案治疗晚期NSCLC 11例,观察其近期疗效及毒副反应.流式细胞法检测治疗前后外周血CECs数量.结果:在可评价疗效的11例患者中,CR 0例,PR 1例,SD 6例,PD 4例.初治患者3例,PR 1例,SD 2例.复治患者9例,其中二线治疗3例,均为SD;三线治疗3例,SD 1例,PD 2例;四线治疗2例,均为PD.该方案用药期间,除Ⅰ～Ⅱ度恶心呕吐及骨髓抑制,3例出现轻度心慌,4例出现轻度乏力,不影响继续用药.7例临床受益患者CECs由(0.67±0.20)%下降为(0.43±0.20)%,4例临床进展患者CECs由(0.69±0.25)%上升为(1.08±0.63)%.结论:YH-16联合 NP方案一线治疗NSCLC疗效满意,有可能使含铂一线甚至多线化疗失败者(身体状况良好者)继续临床受益;该方案安全性较好;CECs可能是一个较好的预测化疗联合抗血管生成治疗疗效的标志.     

晚期非小细胞肺癌一线化疗疗效与生存关系的分析

背景与目的第三代新药组成的方案在晚期NSCLC一线化疗中使大部分患者能够取得疾病控制(CR PR SD),我们进行了本项回顾性分析以探讨一线化疗疾病控制与疾病未控(PD)患者之间生存的差别,以及疾病控制患者有效(CR PR)和稳定(SD)患者之间生存的差别,明确与患者生存有关的预后因素。方法本项回顾性分析纳入了完成第三代新药组成的铂类或非铂类方案一线化疗的118例IIIB期(伴恶性胸水)/IV期NSCLC患者,一线化疗的疗效按RECIST标准根据影像学结果评价为CR,PR,SD,PD四种情况。结果一线化疗后CR PR SD共86例(72.9%)[其中CR2例(1.7%),PR47例(39.8%),SD37例(31.4%)],PD32例(27.1%)。CR PR SD和PD患者MST有统计学差别,为17.8月和8.4月(P=0.001)。CR PR和SD患者MST无统计学差别,为18.1月和15.5月(P=0.917),中位PFS无统计学差别,为7.1月和6.9月(P=0.622)。Cox多因素回归分析显示分期(IIIB期或IV期)、化疗线程(≤3线或≥4线)、一线化疗疾病是否控制是总生存的独立预后因素。结论本研究结果表明,晚期NSCLC患者一线化疗有效和稳定的患者其生存较进展患者好,疾病稳定患者的生存获益与有效患者无明显差别。     

晚期NSCLC一线化疗疾病控制与生存关系的分析

目的回顾性分析一线化疗疾病控制（DCR）与进展（PD）患者之间生存的差别,探讨DCR可否预测生存。方法本文回顾性分析本院一线含铂联合化疗86例ⅢB期/Ⅳ期非小细胞肺癌（NSCLC）患者,化疗的疗效按WHO标准分为CR,PR,SD,PD。结果一线化疗后DCR共64例（74.4%）[其中CR 0例,PR 30例（34.9%）,SD 34例（39.5%）],PD 22例（25.6%）。DCR和PD患者中位生存期（MST）有统计学意义,为14.2月和5.1月（P〈0.001）。CR＋PR和SD患者MST有统计学意义,为15.0月和11.0月（P=0.030）。COX多因素回归分析显示一线化疗疾病控制（P=0.017）,ECOG评分（P=0.046）是总生存的独立预后因素。结论本研究提示晚期NSCLC患者一线化疗疾病控制患者其生存较进展患者好,疾病控制比化疗有效似乎更能反映化疗疗效,预测生存期。     

恩度联合顺铂局部治疗非小细胞肺癌合并恶性胸腔积液的疗效及对VEGF、HIF-1α的影响

目的观察恩度联合顺铂局部治疗非小细胞肺癌(NSCLC)合并胸腔积液的疗效及对积液中VEGF、HIF-1的影响。方法选取30例NSCLC合并恶性胸腔积液患者为研究对象,均采用顺铂联合恩度胸腔局部注入治疗,并在治疗前、后抽取患者3 ml胸腔积液,酶联免疫吸附法测定血清VEGF、HIF-1α水平。观察局部化疗的临床效果,分析不同疗效患者VEGF、HIF-1α水平的变化。结果所有患者均完成2周化疗,其中CR 1例,PR 9例,SD 12例,PD 8例,总有效率为33.3%,疾病控制率为73.3%,随访至今,中位缓解时间为65 d(7~354 d)。所有患者对局部灌注化疗耐受性较好,未出现严重不良反应,10例患者生存质量改善。按照临床疗效将30例患者分为有效组(CR+PR,10例)和无效组(SD+PD,20例),化疗后CR+PR患者胸腔积液中VEGF、HIF-1α水平较化疗前显著降低(P<0.05),而SD+PD患者VEGF、HIF-1α水平稍有上升,但差异不明显(P>0.05)。结论恩度联合顺铂局部灌注治疗晚期NSCLC合并胸腔积液具有一定的临床效果,不良反应较少,能提高部分患者的生活质量,其作用机制与抑制VEGF、HIF-1α表达水平有关。     

沙利度胺对肺癌患者治疗前后血清VEGF水平的影响及临床意义

目的 观察沙利度胺联合第三代化疗药含铂方案治疗晚期非小细胞肺癌(NSCLC)的临床疗效及治疗前后血清中VEGF水平的变化.方法 66例经病理或细胞学证实的初治ⅢB～Ⅳ期NSCLC患者随机分为两组,其中联合组35例,接受沙利度胺联合第三代含铂方案治疗;单化组31例,接受第三代含铂方案化疗.并用ELISA方法检测患者治疗前后血清VEGF的浓度.结果 联合组有效率(CR+PR)为45.7%,临床受益率(CR+PR+SD)为77.1%,中位疾病进展时 间(TTP)为114d;单化组有效率38.7%,临床受益率58.1%,中位TTP为89d,两组有效率差异无统计学意义(P＞0.05);两组临床受益率差异虽然无统计学意义(P=0.055),但联合组略高于单纯化疗组;两组治疗2周期后血清VEGF浓度均显著下降(P=0.000),两组PR、SD的病人治疗后VEGF浓度均下降明显,而PD的病人治疗前后VEGF浓度无明显变化.经沙利度胺干预后患者血清VEGF浓度的下降与单化组比较差异无统计学意义(P=0.513).结论 沙利度胺与第三代化疗药含铂方案联合应用,可提高非小细胞肺癌患者的临床受益率,但未观察到沙利度胺干预能使患者血清VEGF浓度明显下降.     

活化血管内皮细胞检测与非小细胞肺癌抗血管生成治疗疗效的相关性研究

  目的   检测非小细胞肺癌（NSCLC）患者外周血中活化血管内皮细胞（aCECs）数量,分析其与抗血管生成疗效的关系,以期寻找能够早期反映抗血管生成疗效的标志物。   方法   将142例NSCLC患者分为化疗组和联合组（化疗+恩度）,应用流式细胞术检测患者各个治疗周期外周血中CD105和CD146的表达状态,观察以其标记的aCECs变化趋势并分析其与疗效的相关性。   结果   联合组在第8天、第29天、第2个周期后、第50天、第71天、第4个周期后aCEC均较基线明显升高（P < 0.05）,其中疾病进展（progression disease,PD）患者于治疗后aCECs升高更为显著,治疗后较基线升高均有统计学意义（P < 0.05）。治疗周期与治疗前后aCECs差值呈负相关（r=-0.970,P=0.001）,治疗后aCECs的变化差值与TTP间呈负相关（r=-0.351,P=0.039）。   结论   CD105和CD146能够反映内皮细胞的活化状态,对药物治疗反应敏感,可作为aCECs的理想标志物;肿瘤进展时aCECs呈上升趋势,抗血管生成有效治疗使其波动下降;检测aCECs数目,可以帮助预判抗血管生成治疗疗效。      

125I粒子联合化疗治疗非小细胞肺癌

目的探讨125I粒子联合化疗治疗非小细胞肺癌(NSCLC)的临床效果及并发症.方法治疗组(42例)采用CT引导下、PD(处方剂量)=8～10Gy/h植入125I粒子,3 d后紫杉醇+DDP静脉化疗,对照组(46例)单纯紫杉醇+DDP静脉化疗,药物剂量与治疗组参考标准相同.2个月后观察治疗效果(CR,PR,SD,PD).根据生活质量量表EORTC QLQ-C30评价生活质量.结果技术成功率100%,术后随访率100%.治疗组CR 4例(9.5%),PR 14例(33.3%),SD 20例(47.6%),PD4例(9.5%),CR+PR为42.9%;对照组CR 1例(2.2%),PR 8例(17.4%),SD 22例(47.8%),PD 15例(32.6%),CR+PR为19.6%,治疗组总有效率明显高于对照组(P＜0.05).结论对于非小细胞肺癌,125I粒子联合化疗具有优势互补作用,有利于短期内降低肿瘤负荷,提高近期疗效.     

非小细胞肺癌化疗前后外周血LUNX mRNA检测的临床意义

 目的 通过检测中晚期非小细胞肺癌（NSCLC）患者外周血中循环癌细胞的Lunx mRNA表达情况,探讨全身化疗对外周血循环癌细胞的影响。 方法 NSCLC组为63例中晚期NSCLC患者,化疗方案为含铂类的两药联合方案,化疗2周期后评价客观疗效。分别在化疗前、化疗1周期后、化疗2周期后抽取外周血静脉血。肺部良性疾病患者10例和健康志愿者10例为对照组。用RT PCR法检测外周血中循环癌细胞Lunx mRNA的表达情况。 结果 NSCLC组化疗前外周血Lunx mRNA阳性表达率为73.02%,而肺部良性疾病患者和健康志愿者外周血均没有表达。外周血循环癌细胞Lunx mRNA表达情况与年龄、性别、不同病理类型、行为状态评分的关系不密切,而与临床分期密切相关（P=0.04）。化疗完成2周期的60例中CR 0例,PR 21例、SD 23例、PD16例。外周血Lunx mRNA阳性率在化疗1周期和2周期后均为38.33%,较化疗前显著降低（P=0.00）。Lunx mRNA阳性率在PR、SD、PD三个亚组分别为23.81%、26.09%、75.00%,PR组和SD组的阳性率较化疗前显著降低（P=0.01、P=0.00）,而PD组与化疗前 相比差异无统计学意义（P=0.65）。 结论 Lunx mRNA是检测NSCLC外周血微转移的良好分子标志物。患者临床分期越晚,外周血循环癌细胞阳性率越高。全身化疗可显著降低有效或稳定患者的外周血循环癌细胞检出率,对病情进展的患者则没有作用,而且这种变化在化疗初始阶段即已出现,可帮助我们提前判断化疗对病情的控制情况,从而制定更合理的治疗计划。     

VIP化疗方案治疗小细胞肺癌的疗效观察

目的　评价VIP化疗方案 (异环磷酰胺 +顺铂 +鬼臼乙叉甙 )对小细胞肺癌 (SCLC)的治疗价值。方法　按入院顺序随机将 12 0例局限型SCLC初治患者分成VIP治疗组和EP治疗组 (顺铂 +鬼臼乙叉甙 ) ,分别治疗 3周期后评价各组的完全缓解 (CR)、部分缓解 (PR)、稳定 (SD)、进展 (PD)和总有效率 (RR) ,并比较各组的毒副反应发生率。此外 ,还对 2 5例EP方案治疗失败的SCLC患者 ,采用VIP方案解救治疗 ,观察其CR、PR、SD、PD和RR。结果　在 118例可评价的患者中 ,两方案对初治局限型SCLC患者的RR分别为89.6%和 78.3 % (P >0 .0 5 ) ,其毒性反应相当 ,但VIP方案的CR率为 43 .1% ,明显高于EP方案 ( 2 5 .0 % ) (P<0 .0 5 ) ;VIP方案对EP方案治疗无效或复发病例CR率为 13 .0 % ,PR率为 3 9.1% ,PD为 47.8% ,RR为5 2 .2 %。结论　VIP方案作为局限型SCLC患者的一线方案疗效优于标准EP方案 ,而且还可用于EP方案治疗失败病例的解救治疗。     

肿瘤患者循环血管内皮干/祖细胞的检测及体外诱导分化

目的　证实外周血中循环血管内皮细胞 (CECs)及血管内皮前体细胞 (CEPs)的存在 ,检测内皮前体细胞的增殖分化能力。方法　应用流式细胞术检测 5 7例肿瘤患者及 15例正常人外周血中的CECs和CEPs ,应用ELISA方法检测血清VEGF水平。选择经造血干细胞动员的肿瘤患者 ,分离单个核细胞 (MNCs) ,在VEGF、IGF及bFGF条件下培养血管内皮细胞 ,并应用透射电镜法对培养细胞进行鉴定。结果　肿瘤患者外周血中CECs、CEPs含量分别为 0 .3 78%± 0 .0 47%、0 .0 5 9%± 0 .0 13 % ,高于正常对照组 ,且与血清VEGF水平相关。透射电镜下培养细胞可见Weibel-Palade小体 ,为血管内皮细胞的特异性标志。结论　外周血中存在CECs和CEPs ,在肿瘤患者体内存在血管内皮及其前体细胞的动员 ,循环血管内皮干 /祖细胞可进一步分化成熟     

Increased levels of viable circulating endothelial cells are an indicator of progressive disease in cancer patients.

BACKGROUND: There is accumulating evidence from preclinical studies that circulating endothelial cells (CECs) play an important role in neovascularization and tumor growth. The role of CECs in human cancer progression is sparsely investigated. We therefore analyzed CECs in peripheral blood of cancer patients. In addition, we correlated CEC levels in these patients with plasma levels of cytokines that are known to mobilize CECs in experimental models. PATIENTS AND METHODS: Viable CECs were isolated, quantified and cultured from cancer patients' whole blood by using magnetic beads coupled to an antibody directed against CD146, a pan-endothelial marker. Viable cells were visualized by calceinAM staining. Positive staining for specific endothelial cell markers [i.e. von Willebrand factor, CD31, vascular endothelial cell growth factor (VEGF) receptor-2] was used to confirm the endothelial phenotype. RESULTS: Cancer patients with progressive disease (95 patients) had on average 3.6-fold more CECs than healthy subjects (46 patients, P <0.001). Patients (17) with stable disease had CEC numbers equal to that circulating in healthy subjects (P = 0.69). A subset of in vitro cultured CECs incorporated into endothelial layers and formed colonies. Plasma levels of cytokines that are thought to mobilize CECs from the bone marrow [VEGF, placental growth factor, stromal cell derived factor 1alpha and stem cell factor (71 patients)] did not correlate with CEC amounts. The levels of viable CECs in cancer patients were modified by granulocyte colony-stimulating factor treatment and chemotherapy. CONCLUSION: In progressive cancer patients, the amount of CECs is increased. These CECs are viable and may contribute to vessel formation. The number of CECs is influenced by anticancer treatment.     

外周血中循环血管内皮细胞及血管内皮前体细胞的扩增与鉴定

目的证实外周血中循环血管内皮细胞(circulating endothelial cells,CECs)及血管内皮前体细胞(circulating endothelial precursors,CEPs)的存在,以及内皮前体细胞的增殖分化能力.方法应用流式细胞法检测57例肿瘤患者及15例正常人外周血中的CECs/CEPs.选择经造血干细胞动员的肿瘤患者,分离单个核细胞(mononuclear cells,MNCs),在VEGF、IGF及bFGF条件下培养血管内皮细胞,并应用透射电镜法对培养细胞进行鉴定.结果肿瘤患者外周血中CECs/CEPs含量分别为0.378±0.047%、0.059±0.013%,高于正常对照组.培养细胞透射电镜下可见Weibel-Palade小体,为血管内皮细胞的特异性标志.结论外周血中存在CECs/CEPs,在肿瘤患者体内存在血管内皮及其前体细胞的动员,循环血管内皮干/祖细胞可进一步分化成熟.     

Meta-Analysis of Circulating Endothelial Cells and Circulating Endothelial Progenitor Cells as Prognostic Factors in Lung Cancer

Background: The aim of this study was to analyze the prognostic implications of pretreatment circulatingendothelial cells (CECs) and circulating endothelial progenitor cells (CEPCs) for the survival of patients withlung cancer. Materials and Methods: Relevant literature was identified using Medline and EMBASE. Patientclinical characteristics, overall survival (OS) and progression-free survival (PFS) together with CEC andCEPC positive rates before treatment were extracted. STATA 12.0 was used for our analysis and assessment ofpublication bias. Results: A total of 13 articles (8 for CEC and 5 for CEPC, n=595 and n=244) were pooled forthe global meta-analysis. The odds ratio (OR) for OS predicted by pretreatment CECs was 1.641 [0.967, 2.786],while the OR for PFS was 1.168 [0.649, 2.100]. The OR for OS predicted by pretreatment CEPCs was 12.673[5.274, 30.450], while the OR for PFS was 4.930 [0.931, 26.096]. Subgroup analyses were conducted accordingto clinical staging. Odds ratio (OR) showed the high level of pretreatment CECs only correlated with the OSof patients with advanced lung cancer (stage III-IV). Conclusions: High counts of CECs seem to be associatedonly with worse 1-year OS in patients with lung cancer, while high level of pretreatment CEPCs correlate withboth worse PFS and OS.     

Evaluation of circulating endothelial cells, VEGF and VEGFR2 serum levels in patients with chronic myeloproliferative diseases

Authors evaluated some markers of angiogenetic activity in patients with chronic myeloproliferative diseases (CMDs). In this study by using a cytofluorimetric analysis we evaluated circulating endothelial progenitor cells (EPCs) in patients with chronic myeloproliferative disease. Moreover, in the same group of subjects, we evaluated serum levels of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR2). In our patients, we have found an increase in the number of endothelial progenitor cells in primary myelofibrosis (PMF) and polycythaemia vera (PV) patients, while an increase of circulating endothelial cells (CECs) was found in all patients with CMD. Moreover, we found higher serum levels of VEGF with respect to control subjects in every group of patients with CMD, and a not significant reduction of VEGFR2 levels in essential thrombocythaemia (ET) patients. A correlation was also found in PV patients between VEGF levels and erythrocyte number and in PMF subjects with the count of white cells. Our data suggest that some markers of angiogenesis are activated in CMD patients and angiogenesis may have a role in the pathophysiology of chronic myeloproliferative disorders.     

血管内皮抑制素对Calu-6裸鼠移植瘤的生物学效应

目的 探讨血管内皮抑制素对Calu-6裸鼠移植瘤生长及新生血管形成的影响.方法 在荷瘤裸鼠皮下注射不同剂量的血管内皮抑制素,观察注射后肿瘤体积的变化;应用免疫组化SABC法检测肿瘤组织中血管内皮生长因子(VEGF)、生存素(survivin)和环氧化酶-2(COX-2)蛋白的表达以及微血管密度(MVD)的变化;流式细胞术检测循环血管内皮细胞(CECs)的含量;应用逆转录聚合酶链反应(RT-PCR)和实时定量PCR检测外周血中CD146和CD105 mRNA的表达.结果经血管内皮抑制素治疗后,荷瘤鼠肿瘤体积明显减小;肿瘤组织中VEGF、survivin和COX-2蛋白的表达以及MVD均下降,且各治疗组与阳性对照组间的差异均有统计学意义(均P＜0.05);外周血中CECs、CD146和CD105 mRNA的含量均明显下降;活化CECs的含量与肿瘤组织中survivin和VEGF的表达以及MVD的变化均呈正相关.结论 血管内皮抑制素可通过下调移植瘤中VEGF、survivin和COX.2蛋白的表达以及减少MVD抑制肿瘤生长;活化CECs将可能作为理想的预测抗血管形成治疗预后的标记物应用于临床.     

肺癌患者血清VEGF含量检测的临床意义

目的　探讨肺癌患者血清血管内皮生长因子 (VEGF)含量变化的意义及其影响肺癌生长及转移的作用机制。方法原发性支气管肺癌 63例 ,采用免疫组化染色检测肺癌组织VEGF表达情况 ,酶联免疫吸附试验 (ELISA)测定血清VEGF含量 ,采用Kaplan Meier方法比较不同血清VEGF含量者的生存情况。 结果　肺癌患者血清VEGF含量明显高于正常对照组 ,不同性别、年龄、组织学类型、分化程度及T分期 (肿瘤原发状态 )血清VEGF含量无显著性差异 ,不同N分期 (淋巴结转移 )及临床分期间血清VEGF含量有显著性差异。肺癌患者血清VEGF含量与肺癌组织VEGF表达呈正相关。血清VEGF高含量患者生存时间明显短于血清VEGF低含量者。结论　血清VEGF与肺癌淋巴结转移及临床分期进展密切相关 ,血清VEGF含量可作为判断肺癌淋巴结转移潜能及预后评价的可靠参考指标。肺癌细胞分泌VEGF进入血液循环 ,从而促进肺癌的生长及转移     

Differential effects of vascular endothelial growth factor receptor-2 inhibitor ZD6474 on circulating endothelial progenitors and mature circulating endothelial cells: implications for use as a surrogate marker of antiangiogenic activity.

PURPOSE: Circulating endothelial cells (CEC) comprise at least two distinct populations: bone marrow-derived circulating endothelial progenitors (CEP) and mature CECs derived from existing vasculature. We hypothesized that antiangiogenic agents may have differential effects on CEPs and mature CECs and that these changes may serve as a marker of biological activity. EXPERIMENTAL DESIGN: The effect of angiogenesis inhibitors on CECs was evaluated by flow cytometry after vascular endothelial growth factor (VEGF)-induced mobilization and in mice bearing Lewis lung carcinoma (LLC). Tumor angiogenesis was evaluated in parallel by immunohistochemistry. RESULTS: In nontumor-bearing mice, VEGF administration increased both mature CECs and CEPs. This increase was inhibited by the VEGF receptor 2 inhibitor ZD6474 as well as the VEGF inhibitor-soluble Flt-1. ZD6474 had no significant effect on CECs in the absence of exogenous VEGF stimulation. In contrast, LLC-bearing mice had an increase in mature CECs but not CEPs after 3 days of treatment with ZD6474. The increase in mature CECs was dose-dependent, accompanied by a decrease in tumor microvessel density, and preceded reduction in tumor volume. Treatment of LLC-bearing mice with the vascular targeting agent ZD6126 also increased mature CECs. CONCLUSIONS: VEGF inhibitors can have differential effects on mature CECs and CEPs, and agents inhibiting tumor angiogenesis may cause a concomitant increase in mature CECs. This increase occurs in tumor-bearing but not in nontumor-bearing mice, suggesting that tumor endothelium is a potential source of mature CECs. Therefore, assessing both mature CECs and CEPs may provide insights into the mechanism of antiangiogenic agents and serve as an early surrogate marker of biological activity.     

非小细胞肺癌患者血清VEGF表达水平及其临床意义

目的：检测非小细胞肺癌（NSCLC）患者血清血管内皮生长因子（vascula rendothelial growth factor,VEGF）的表达水平,探讨其临床意义。方法：应用酶联免疫吸附法（ELISA）检测114例NSCLC和87例健康对照组血清中VEGF水平,计算VEGF的灵敏度和特异度,阳性预测值和阴性预测值,分析患者治疗前血清VEGF水平对其近期疗效的影响以及VEGF与CYFRA21-1和CEA联合检测的临床意义。结果：（1）NSCLC组血清VEGF平均水平为203.70ng/L,对照组为76.21ng/L,两组差别有统计学意义（P〈0.001）。有负荷组患者血清VEGF水平高于无负荷组（P〈0.001）。（2）VEGF以200.6ng/L为医学参考值上限,VEGF对NSCLC诊断的灵敏度为69.7%,特异度为96.4%;有负荷组患者灵敏度可达到81.9%,而无负荷组仅为33.7%,其差别有统计学意义（P〈0.01）。（3）NSCLC患者随着血清VEGF平均水平的升高,其疗效逐渐降低（P〈0.05）。3种肿瘤标记物联合分析显示,随着患者血清肿瘤标记物阳性数目的增多,无效患者的比例呈上升趋势,当患者血清肿瘤标记物阳性数目达到3种时,约87.5%的患者治疗无效。（4）血清VEGF水平与肿瘤大小、分化程度及临床分期密切相关（P〈0.01）,与患者的年龄无关（P〉0.05）。结论：VEGF在NSCLC的发生、生长和转移过程中起着极其重要的作用,有可能成为一种新的肿瘤标记物用于NSCLC的辅助诊断或检测指标。