Abstract
e18024 Background: Circulating tumor cell (CTC), a surrogate of distant metastasis, and circulating endothelia cell (CEC), a surrogate of angiogenesis, are potentially useful in the diagnosis of malignant tumors, but clinical significance of CTC/CEC in the diagnosis of malignant pleural mesothelioma (MPM) remains unknown. Methods: We conducted a single institutional prospective study to evaluate the diagnostic performance of CTC/CEC, and patients who presented with suspicion or diagnosis of MPM were eligible. CTC/CEC in peripheral blood (7.5 mL/4.0 mL, respectively) were captured and quantitatively evaluated with the “CellSearch” system without knowledge of clinical characteristics of each case. Results: Among 114 eligible cases, 92 were finally diagnosed as having MPM and 22 as nonmalignant diseases (NM). CTC was positive (CTC-count, one or more) in 38% of MPM cases, and was also positive in 14% of NM cases. CTC-count was significantly higher in MPM (range, 0-27) than in NM (range, 0-1), but a receiver operating characteristic (ROC) curve analysis failed to show a significant diagnostic performance of the CTC-test in discrimination between MPM and NM. CEC-count was significantly higher in MPM than in NM, and also provide a significant diagnostic value in discrimination between MPM and NM with the AUC-ROC of 0.782 (p<0.01). In addition, metastatic MPM cases showed a significantly higher mean CEC-count than nonmetastatic MPM cases (117 vs. 67, p<0.05). Conclusions: CTC/CEC are potentially useful clinical markers in the diagnosis of MPM, and the clinical value should be validated in future clinical trials. This study was supported by “The Special Coordination Funds for Promoting Science and Technology from the Japanese Ministry of Education, Culture, Sports, Science, and Technology.” MPM Nonmalignant No. of pts n = 92 n = 22 CTC count (/7.5 mL) ~0 (negative) n = 57 (62%) n = 19 (86%) 1 n = 22 (24%) n = 3 (14%) p = 0.037 2 or more n = 13 (14%) - AUC-ROC = 0.541 (0.415-0.666; p = 0.556) CEC count (/4.0 mL)(mean) 91 53 p = 0.031 AUC-ROC = 0.782(0.675-0.888; p < 0.01) No significant financial relationships to disclose.
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