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OBJECTIVE To analyze the relationship between the characteristics of PET/CT images for lung carcinoma (LC) TNM staging and the expression of serum VEGF protein.METHODS PET/CT examinations were performed before treatment of 53 patients with LC. The expression of serum VEGF protein was examined using a quantitative sandwich enzyme-linked immunosorbent assay (ELISA R and D system). The relationship was analyzed between PET/CT images for LC T-staging and metastasis (lymph nodes and distance) and serum VEGF expression.RESULTS Based on PET/CT images for LC T-staging, 11 cases were staged as T1, 9 as T2, 18 as T3 and 15 as T4. Mediastinal nodal metastases were found in 22 patients, and distance metastasis in 9. The serum VEGF level in the LC patients was (378.02±180.79) ng/L, showing that there was a significant difference between the patients and healthy subjects (P＜0.05).There was no significant difference in the level of serum VEGF between different low T-staged (T1, T2) patients. However, the level of serum VEGF was significantly different between the low T-staged (T1, T2) and high T-staged (T3, T4) patients (P＜0.05). The level of the serum VEGF protein in the patients with mediastinal nodal metastasis was (561.50±104.55) ng/L, and indicating that there was a statistical significance (t=12.21, P＜0.05) compared to those in the non-metastatic group. The level of serum VEGF in the patients with distance metastasis was (614.11±158.81) ng/L, demonstrating that there was a significant difference (t=5.30, P＜0.05) compared to those in the nondistant metastatic group.CONCLUSION ①There is a high level of serum VEGF xpression in LC patients. ②There is a correlation between metastases (lymph nodes and distance) and the level of serum VEGF. ③With an upgrade of the TNM-stage, the level of serum VEGF protein is elevated.