Abstract
Increased values of circulating microparticles (MPs) have been reported in solid tumors including non-small cell lung cancer (NSCLC). We therefore investigated the utility of baseline MPs in the clinical setting of patients with NSCLC. Quantification of MPs in the plasma was performed by flowcytometry. Baseline MP values were correlated with clinical patients' characteristics, estimated tumor volume (ETV) and treatment response. Receiver operating characteristics (ROC) curves were plotted to discriminate between patients and controls in order to determine the diagnostic value of circulating MPs in NSCLC. Our prospective study included 134 NSCLC patients (98 at initial diagnosis, ID and 36 at relapse, R) and 30 healthy individuals. The mean of baseline MP numbers was significantly higher in patients presented either at ID or R than in controls (p<0.0001). Basal MP numbers were inversely correlated with ETV values (p=0.04). In addition, the difference in MP levels at diagnosis was significant according to tumor histology (p=0.02) and primary tumor size (p=0.0007). Using ROC analysis, the optimal cutoff value for baseline MPs was 1307 events/µL with a sensitivity and a specificity of 67.3% and 90.0%, respectively. High MPs expression was significantly associated with low-level smoking degree (p=0.001), non-squamous cell types (p=0.017) and decreased tumor size (p=0.003). Our results suggest that high baseline MP values could be an indicator of tumor growth inhibition in NSSLC. Furthermore, high expression of circulating MPs at diagnosis might predict good prognosis in NSCLC patients.
Highlights
Non-small cell lung cancer (NSCLC) represents about 85% of lung cancer (LC) cases, and most patients have metastatic disease at their initial diagnosis [1]
The mean of baseline MP numbers was significantly higher in patients either at initial diagnosis (ID) or R than in controls, figure (1)
Our results extended the findings outlined in previous reports, and provide a clinically relevant information suggesting baseline MPs as a useful potential biomarker in the clinical setting of NSCLC
Summary
Non-small cell lung cancer (NSCLC) represents about 85% of lung cancer (LC) cases, and most patients have metastatic disease at their initial diagnosis [1]. Adjuvant chemotherapy improved survival in patients with completely resected early-stage NSCLC, while standard chemotherapy relatively prolonged survival rate in NSCLC patients at advanced stages, but it is still low with 5-year survival rate of 2% [3,4,5]. Molecularly targeted drugs have been introduced such as tyrosine kinase epidermal growth factor receptor (EGFR) inhibitors and anaplastic lymphoma tyrosine kinase (ALK) inhibitors [6]. These targeted drugs have become the treatment of choice for NSCLC patients with mutations in EGFR and ALK genes [7,8]
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