Circulating Endothelial Cell (CEC) as a Diagnostic and Prognostic Marker in Malignant Pleural Mesothelioma (MPM)
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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).
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.
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).
CEC, as a surrogate of tumor angiogenesis, was a promising marker in diagnosis and prediction of prognosis in MPM.
KeywordsReceiver Operating Characteristic Tumor Angiogenesis Malignant Pleural Mesothelioma Serum Vascular Endothelial Growth Factor Asbestos Exposure
This study was supported by The Special Coordination Funds for Promoting Science and Technology from the Japanese Ministry of Education, Culture, Sports, Science, and Technology, Grants-in-Aid for Scientific Research (KAKENHI B 24390335) from the Japan Society for the Promotion of Science (JSPS), and UOEH Grant for Advanced Research (H24-1) from University of Occupational and Educational Health.
Conflict of interest
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