Clinical utility of circulating tumor-derived endothelial cells in lung cancer detection and prognosis prediction

Circulating tumor-derived endothelial cells (CTEC) have emerged as promising biomarkers reflecting tumor angiogenesis, disease progression and therapeutic response, although their clinical relevance in lung cancer remains underexplored. A total of 74 patients with lung cancer were enrolled in the present study, and both preoperative and postoperative peripheral blood samples were collected. A total of 20 healthy individuals were included as controls. CTEC (CD31⁺ aneuploid cells) and circulating tumor cells (CTC; CD31^- aneuploid cells) were simultaneously detected using an improved subtraction enrichment and immunostaining-fluorescence in situ hybridization technique. The overall positive detection rates of CTC and CTEC were 68.75 and 81.25%, respectively. CTEC accounted for a greater proportion of circulating rare cells in patients with lung cancer, and CTEC counts were significantly elevated in those with lymph node metastasis compared with CTC. Receiver operating characteristic curve analysis demonstrated that CTEC [area under the curve (AUC), 0.855] performed better than CTC (AUC, 0.673) in distinguishing patients with lung cancer from healthy controls. Furthermore, a preoperative CTEC count ≥1 was identified as an independent risk factor for shorter progression-free survival. These findings suggested that CTEC may serve as reliable supplementary biomarkers for lung cancer screening, disease monitoring and prognosis prediction.