title: Circulating endothelial cell (CEC) as a diagnostic and prognostic marker in malignant pleural mesothelioma (MPM).
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.
authors: Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors: Kazue
authors: K
authors: Yoneda
authors: Fumihiro
authors: F
authors: Tanaka
authors: Nobuyuki
authors: N
authors: Kondo
authors: Hayato
authors: H
authors: Orui
authors: Masaki
authors: M
authors: Hashimoto
authors: Teruhisa
authors: T
authors: Takuwa
authors: Seiji
authors: S
authors: Matsumoto
authors: Yoshitomo
authors: Y
authors: Okumura
authors: Noriaki
authors: N
authors: Tsubota
authors: Ayuko
authors: A
authors: Sato
authors: Tohru
authors: T
authors: Tsujimura
authors: Kozo
authors: K
authors: Kuribayashi
authors: Kazuya
authors: K
authors: Fukuoka
authors: Takashi
authors: T
authors: Nakano
authors: Seiki
authors: S
authors: Hasegawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D016022:Case-Control Studies; D042783:Endothelial Cells / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000098:blood supply / Q000175:diagnosis* / Q000401:mortality; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009389:Neovascularization, Pathologic; D010997:Pleural Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor