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

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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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.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Japan

    Kazue Yoneda BA, Fumihiro Tanaka MD, PhD, Nobuyuki Kondo MD, PhD, Hayato Orui MD, Masaki Hashimoto MD, Teruhisa Takuwa MD, Seiji Matsumoto MD, PhD, Yoshitomo Okumura MD, PhD & Seiki Hasegawa MD, PhD

  2. Department of Thoracic Oncology, Hyogo College of Medicine, Nishinomiya, Japan

    Noriaki Tsubota MD, PhD

  3. Department of Pathology, Hyogo College of Medicine, Nishinomiya, Japan

    Ayuko Sato PhD & Tohru Tsujimura MD, PhD

  4. Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Kozo Kuribayashi MD, PhD, Kazuya Fukuoka MD, PhD & Takashi Nakano MD, PhD

  5. Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Kitakyusyu, Japan

    Fumihiro Tanaka MD, PhD

  6. Department of Thoracic Surgery, Itami City Hospital, Itami, Japan

    Yoshitomo Okumura MD, PhD

Authors
  1. Kazue Yoneda BA
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  2. Fumihiro Tanaka MD, PhD
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  3. Nobuyuki Kondo MD, PhD
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  7. Seiji Matsumoto MD, PhD
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  8. Yoshitomo Okumura MD, PhD
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  11. Tohru Tsujimura MD, PhD
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  12. Kozo Kuribayashi MD, PhD
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  13. Kazuya Fukuoka MD, PhD
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  14. Takashi Nakano MD, PhD
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  15. Seiki Hasegawa MD, PhD
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Corresponding author

Correspondence to Fumihiro Tanaka MD, PhD.

Appendix

Appendix

See Figs. 5, 6 and Table 3

Fig. 5
figure 5

Flowchart of diagnosis of patients enrolled in the study

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Fig. 6
figure 6

Immunohistochemical staining with an anti-CD34 antibody in malignant pleural mesothelioma (MPM) to evaluate intratumoral microvessel density (MVD)

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Yoneda, K., Tanaka, F., Kondo, N. et al. Circulating Endothelial Cell (CEC) as a Diagnostic and Prognostic Marker in Malignant Pleural Mesothelioma (MPM). Ann Surg Oncol 19, 4229–4237 (2012). https://doi.org/10.1245/s10434-012-2506-0

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  • DOI: https://doi.org/10.1245/s10434-012-2506-0

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