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Annals of Surgical Oncology

, Volume 19, Issue 13, pp 4229–4237 | Cite as

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

  • Kazue Yoneda
  • Fumihiro Tanaka
  • Nobuyuki Kondo
  • Hayato Orui
  • Masaki Hashimoto
  • Teruhisa Takuwa
  • Seiji Matsumoto
  • Yoshitomo Okumura
  • Noriaki Tsubota
  • Ayuko Sato
  • Tohru Tsujimura
  • Kozo Kuribayashi
  • Kazuya Fukuoka
  • Takashi Nakano
  • Seiki Hasegawa
Thoracic Oncology

Abstract

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.

Keywords

Receiver Operating Characteristic Tumor Angiogenesis Malignant Pleural Mesothelioma Serum Vascular Endothelial Growth Factor Asbestos Exposure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

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

None declared.

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Kazue Yoneda
    • 1
  • Fumihiro Tanaka
    • 1
    • 5
  • Nobuyuki Kondo
    • 1
  • Hayato Orui
    • 1
  • Masaki Hashimoto
    • 1
  • Teruhisa Takuwa
    • 1
  • Seiji Matsumoto
    • 1
  • Yoshitomo Okumura
    • 1
    • 6
  • Noriaki Tsubota
    • 2
  • Ayuko Sato
    • 3
  • Tohru Tsujimura
    • 3
  • Kozo Kuribayashi
    • 4
  • Kazuya Fukuoka
    • 4
  • Takashi Nakano
    • 4
  • Seiki Hasegawa
    • 1
  1. 1.Department of Thoracic SurgeryHyogo College of MedicineNishinomiyaJapan
  2. 2.Department of Thoracic OncologyHyogo College of MedicineNishinomiyaJapan
  3. 3.Department of PathologyHyogo College of MedicineNishinomiyaJapan
  4. 4.Division of Respiratory Medicine, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
  5. 5.Second Department of Surgery (Chest Surgery)University of Occupational and Environmental HealthKitakyusyuJapan
  6. 6.Department of Thoracic SurgeryItami City HospitalItamiJapan

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