title: Endothelial progenitor cells are mobilized after major laparotomic surgery in patients with cancer.
abstract: The progression of cancer is largely dependent on neoangiogenesis. Circulating endothelial progenitor cells (EPC) have the ability to form complete vascular structures in vitro and play a crucial role in tumor vasculogenesis. Emerging evidence suggests that surgical injury may induce the mobilization of EPC in animal models, and this might have a negative effect on the prognosis of cancer patients. We studied 20 patients (10 men, 65+/-13 years) undergoing laparotomy for surgical treatment of various forms of abdominal cancer, and 20 age- and sex-matched healthy control subjects. The number of circulating EPC, defined as CD34+/KDR+ cells identified among mononuclear cells isolated from peripheral venous blood, was determined preoperatively and at days 1 and 2 after surgery. Surgery induced a significant increase in circulating EPC levels at day 1 (from 278/mL, interquartile range 171-334, to 558/mL, interquartile range 423-841, p<0.001) and day 2 (709/mL, interquartile range 355-834, p<0.001)compared with baseline values. EPC levels did not change in control subjects. Seven subjects who underwent laparotomic surgery for non-neoplastic disease also showed an increase in EPC levels after surgery (p=0.009 and p=0.028 at day 1 and day 2, respectively). We conclude that patients undergoing elective laparotomic surgery for cancer demonstrate an increase in EPC post-operatively. The potential adverse effects of surgical stress-induced EPC mobilization on tumor and metastasis growth in cancer patients need to be addressed in future studies.
authors.affiliation: Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Perugia, Italy. skill@unipg.it
authors.forename: G
authors.initials: G
authors.lastname: Schillaci
authors.forename: F
authors.initials: F
authors.lastname: Rondelli
authors.forename: M
authors.initials: M
authors.lastname: Pirro
authors.forename: F
authors.initials: F
authors.lastname: Bagaglia
authors.forename: G
authors.initials: G
authors.lastname: Pucci
authors.forename: G
authors.initials: G
authors.lastname: Noya
authors.forename: E
authors.initials: E
authors.lastname: Mannarino
mesh_terms: D000008:Abdominal Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D053687:Adult Stem Cells / Q000378:metabolism / Q000473:pathology*; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology*; D016022:Case-Control Studies; D002452:Cell Count; D002465:Cell Movement; D017558:Elective Surgical Procedures; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000378:metabolism
chemical_list: D018952:Antigens, CD34; D040301:Vascular Endothelial Growth Factor Receptor-2