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Published on: March 6, 2019
Circulating endothelial cell (CEC) as a diagnostic and prognostic marker in malignant pleural mesothelioma (MPM)
Kazue Yoneda1, Fumihiro Tanaka, Nobuyuki Kondo
1Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
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.
Insights
Circulating endothelial cells (CECs) show diagnostic and prognostic value in malignant pleural mesothelioma (MPM). Higher CEC counts indicate poor prognosis, making them a promising biomarker for MPM diagnosis and survival prediction.
Area of Science:
- Oncology
- Biomarkers
- Diagnostic Imaging
Background:
- Malignant pleural mesothelioma (MPM) diagnosis and prognosis require reliable biomarkers.
- Circulating endothelial cells (CECs) are potential indicators of tumor angiogenesis.
Purpose of the Study:
- To investigate the diagnostic and prognostic value of CECs in MPM.
- To assess CECs as a surrogate marker for tumor angiogenesis in MPM.
Main Methods:
- Prospective evaluation of CEC count in patients with suspected MPM using peripheral blood samples.
- Automated system with anti-CD146 antibody for CEC capture.
Main Results:
- CEC count was significantly higher in MPM patients (120.3) versus non-malignant (39.9).
- CEC analysis demonstrated significant diagnostic performance (AUC-ROC 0.700) distinguishing MPM from non-malignant diseases.
- Higher CEC count correlated with poor prognosis and was an independent predictor of survival in MPM patients.
Conclusions:
- CECs serve as a promising biomarker for the diagnosis of MPM.
- CEC levels effectively predict prognosis in patients with malignant pleural mesothelioma.
