Circulating Endothelial Cell (CEC) as a Diagnostic and Prognostic Marker in Malignant Pleural Mesothelioma (MPM)

• Published in: Annals of surgical oncology Vol. 19; no. 13; pp. 4229 - 4237
• Main Authors: Yoneda, Kazue, Tanaka, Fumihiro, Kondo, Nobuyuki, Orui, Hayato, Hashimoto, Masaki, Takuwa, Teruhisa, Matsumoto, Seiji, Okumura, Yoshitomo, Tsubota, Noriaki, Sato, Ayuko, Tsujimura, Tohru, Kuribayashi, Kozo, Fukuoka, Kazuya, Nakano, Takashi, Hasegawa, Seiki
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.12.2012; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Area Under Curve; Biomarkers, Tumor - analysis; Case-Control Studies; Endothelial Cells - pathology; Female; Follow-Up Studies; Humans; Male; Medicine; Medicine & Public Health; Mesothelioma - blood supply; Mesothelioma - diagnosis; Mesothelioma - mortality; Middle Aged; Neoplasm Staging; Neoplastic Cells, Circulating - pathology; Neovascularization, Pathologic; Oncology; Pleural Neoplasms - blood supply; Pleural Neoplasms - diagnosis; Pleural Neoplasms - mortality; Prognosis; Prospective Studies; Surgery; Surgical Oncology; Survival Rate; Thoracic Oncology; Asbestos Exposure; Malignant Pleural Mesothelioma; Tumor Angiogenesis; Serum Vascular Endothelial Growth Factor; Receiver Operating Characteristic
• ISSN: 1068-9265; 1534-4681; 1534-4681
• DOI: 10.1245/s10434-012-2506-0

Background The purpose of this study was to investigate the diagnostic and prognostic value of circulating endothelial cell (CEC), a potential surrogate of tumor angiogenesis, in malignant pleural mesothelioma (MPM). Methods We prospectively evaluated CEC count in 4.0 mL of peripheral blood sampled from patients with a suspicion of MPM. An automated system was used to capture CECs with an anti-CD146 antibody. Results Of 109 eligible patients, 30 were finally diagnosed with non-malignant diseases, and 79 were with MPM. CEC count was significantly higher in MPM patients than in NM patients (mean CEC count, 120.3 and 39.9, respectively; P  = 0.001), and a receiver operating characteristic (ROC) curve analysis showed that CEC provided a significant diagnostic performance in discrimination between MPM and nonmalignant diseases with an area under curve (AUC–ROC) of 0.700 (95 % confidence interval [95 % CI], 0.595–0.806; P  = 0.001). Among MPM patients, CEC count was positively correlated with intratumoral microvessel density (MVD), a measurement of tumor angiogenesis (Spearman correlation coefficiency [ r ] = 0.444; P = 0.001). Higher CEC count (>50) was significantly associated with a poor prognosis (median overall survival, 11.4 months [95 % CI, 7.6–15.2] for higher CEC count patients versus 20.1 months [95 % CI, 16.0–24.2] for lower CEC count patients; P  = 0.028). A multivariate analysis showed that higher CEC count was a significant and independent factor to predict a poor prognosis (hazard ratio [HR], 2.24, [95 % CI, 1.24–4.43]; P  = 0.009). Conclusions CEC, as a surrogate of tumor angiogenesis, was a promising marker in diagnosis and prediction of prognosis in MPM.