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目的：研究血管生成拟态在非小细胞肺癌患者中的发生机制及其与化疗敏感性的关系。方法：收集42 例NSCLC 患者，分为早期组（I+II期，共19名）和晚期组（III+IV 期，共23 名）。20 名接受手术治疗，22 名仅行铂二联化疗，并且化疗组按2 周期化疗疗效分有效组（疗效评价CR+PR,7 名）和无效组（疗效评价SD+PD，15名）。对比分析VM 与分期、化疗疗效、HIF-1琢及各种临床病理特征是否有关。结果：早期组NSCLC 患者VM阳性率明显高于晚期组（68.4%VS 26.1%，p=0.006），VM阳性组HIF-1琢阳性率明显高于VM阴性组（P=0.034）。化疗有效组与无效组之间VM未见明显差异（P＞0.05）。淋巴结转移及无远处转移组分别较无淋巴结转移及远处转移组VM阳性率高（P＜0.05）。VM与患者性别、年龄、病理类型、肿瘤大小及分化程度无关（P＞0.05）。结论： VM 作为一种新发现的肿瘤供血方式，其形成主要在NSCLC 早期，并且VM的存在与淋巴结转移有关，随着疾病进展，VM逐渐减少。目前尚未发现VM与NSCLC 化疗敏感性有关，但HIF-1琢在VM 形成中起重要作用，VM有可能成为一个新的靶向治疗的靶点，为临床分期及诊疗提供帮助。

英文摘要:

Objective:To study the mechanism of vasculogenic mimicry (VM) and its relation with chemotherapy in non-small cell lung cancer (NSCLC).Methods:42 patients with NSCLC were collected, 19 belonged to the early stage (stage I+II) while 23 were late stage (stage III+IV). Moreover, 20 patients got surgical treatment and 22 got chemotherapy. We studied the relationship of VMwith stage, chemotherapeutic effect , HIF-1alpha, MVD and clinicopathologic features.Results:VM in patients of early stages were significantly more than late stages (68.4% VS 26.1%, P=0.006), but no significant difference was found between effective and noneffective chemotherapy group (14.3%VS 26.7%, P=1.00). Furthermore, the positive rate of VMwas proportional to HIF-1琢(p=0.034). VMalso showed a negative correlation with distant metastases and positive correlation with lymph nodes metastases (P＜0.05) while no correlation was found between VM and other clinicopathologic including sex, age, pathological pattern, tumor size and differentiation (P＞ 0.05). Conclusion:VMwas generated during the early stage in NSCLC and correlated with lymph nodes metastases. As the disease progressed,VMmay be replaced by vascular endothelial cells. No evidence has been found to demonstrate the correlation between VMand chemosensitivity. However, HIF-1alphamay make a difference in VMformation. Thus VMmight be a novel therapeutic target, and used for clinical staging and treatment.

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