title: Determining circulating endothelial cells using CellSearch system during preoperative systemic chemotherapy in breast cancer patients.
abstract: BACKGROUND
  Circulating endothelial cells (CECs) have been studied as a biomarker for tumour progression and monitoring therapeutic effects. The CellSearch system is a semi-automated system that allows standardised analysis of CECs. This study assessed the clinical implications of CECs determined by the CellSearch system in breast cancer patients.
  
  
  METHODS
  Seventy-six consecutive breast cancer patients (53 operable and 23 metastatic or recurrent) were enrolled for the study. Thirty-five patients with operable breast cancer received preoperative chemotherapy with a regimen based on anthracycline and/or taxane. CECs are defined as CD146(+)CD105(+)CD45(-)DAPI(+) cells in the system. CD34 expression was examined using the additional channel in the system.
  
  
  RESULTS
  A majority (4539 of 5183 cells, 88%) of CECs from patients with operable breast cancer were CD34-positive. Triple-negative cancers showed higher baseline CEC and CD34(+)CEC counts than the other types (P=0.0387 and 0.0377, respectively). Low baseline CEC and CD34(+)CEC counts, and a low CD34 positive rate were associated with pathological complete response (pCR) of preoperative chemotherapy in patients with primary breast cancer (P=0.046, 0.027 and 0.01, respectively). In multivariate analyses, the CD34 positive rate was significant for pCR (P=0.021). During preoperative chemotherapy, CEC and CD34(+)CEC counts before each cycle of chemotherapy increased with taxane-based regimens (P=0.0018 and 0.0008, respectively) but not with anthracycline-based regimens.
  
  
  CONCLUSIONS
  Baseline CEC, in particular CD34(+)CEC, counts and the CD34 positive rate might be useful for the prediction of treatment response of preoperative chemotherapy in patients with operable breast cancer.
authors: Department of Surgery (Breast Surgery), Graduate School of Medicine, Kyoto University, 54 Kawaracho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
authors: Arwa M
authors: AM
authors: Ali
authors: Takayuki
authors: T
authors: Ueno
authors: Sunao
authors: S
authors: Tanaka
authors: Masahiro
authors: M
authors: Takada
authors: Hiroshi
authors: H
authors: Ishiguro
authors: Ashraf Z
authors: AZ
authors: Abdellah
authors: Masakazu
authors: M
authors: Toi
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018943:Anthracyclines / Q000008:administration & dosage; D015703:Antigens, CD / Q000032:analysis; D018952:Antigens, CD34 / Q000032:analysis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D057205:Automation, Laboratory; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D051929:CD146 Antigen / Q000032:analysis; D017024:Chemotherapy, Adjuvant; D000071063:Endoglin; D005260:Female; D006801:Humans; D018189:Immunomagnetic Separation; D016130:Immunophenotyping / Q000379:methods*; D007564:Japan; D017493:Leukocyte Common Antigens / Q000032:analysis; D016015:Logistic Models; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009360:Neoplastic Cells, Circulating / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D018579:Patient Selection; D011237:Predictive Value of Tests; D011956:Receptors, Cell Surface / Q000032:analysis; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D015703:Antigens, CD; D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D051929:CD146 Antigen; C064206:ENG protein, human; D000071063:Endoglin; C497902:MCAM protein, human; D011956:Receptors, Cell Surface; D043823:Taxoids; D017493:Leukocyte Common Antigens; C516769:PTPRC protein, human