title: Circulating endothelial cells as a biomarker in non-small cell lung cancer patients: correlation with clinical outcome.
abstract: BACKGROUND
  Circulating endothelial cells (CECs) have been proposed as a biomarker for the assessment of patients with solid tumors. However, few data are available in non-small cell lung cancer (NSCLC). We therefore analyzed the clinical significance of CECs in newly diagnosed NSCLC patients. In addition, we tried to determine the prognostic value of CECs in NSCLC.
  
  
  METHODS
  In this prospective study, 151 newly diagnosed NSCLC patients and 25 healthy volunteers were included. Furthermore, 25 patients with a partial response (n=15) or stable disease (n=10) after treatment were evaluated at recurrence with a mean follow-up of 117 days (range: 47-364 days). CECs were counted using magnetic beads coupled to a specific antibody against CD146.
  
  
  RESULTS
  The pre-treatment CEC count was significantly higher in patients with all histological subtypes of NSCLC than in healthy volunteers (p&lt;0.0001). High baseline CEC counts were significantly correlated with advanced clinical stages (p=0.026), weight loss (p=0.03), and poorly differentiated NSCLC (p=0.02). The amount of CECs increased significantly at recurrence compared with their amount after treatment in 20/21 assessable patients (p=0.0001). Nevertheless, there was no significant correlation between baseline CEC count and median duration of progression-free survival (p=0.402).
  
  
  CONCLUSIONS
  Increased CEC counts were present in patients with newly diagnosed NSCLC compared with healthy subjects. Elevated levels of baseline CECs correlated with high-risk factors in NSCLC. In addition, increased CEC count during follow-up seems to be correlated with recurrence in NSCLC patients.
authors.affiliation: 1 Department of Radiation Medicine, Biomarkers Laboratory, Atomic Energy Commission of Syria (AECS), Damascus - Syria.
authors.forename: Fadi
authors.initials: F
authors.lastname: Najjar
authors.forename: Moosheer
authors.initials: M
authors.lastname: Alammar
authors.forename: Marroan
authors.initials: M
authors.lastname: Bachour
authors.forename: Ghassan
authors.initials: G
authors.lastname: Al-Massarani
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D051929:CD146 Antigen / Q000276:immunology; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000401:mortality / Q000473:pathology*; D002452:Cell Count; D018572:Disease-Free Survival; D042783:Endothelial Cells / Q000166:cytology*; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D014408:Biomarkers, Tumor; D051929:CD146 Antigen; C497902:MCAM protein, human