Circulating Endothelial Cells and Microparticles as Prognostic Markers in Advanced Non-Small Cell Lung Cancer

Abstract

BackgroundCirculating endothelial cells and microparticles have prognostic value in cancer, and might be predictors of response to chemotherapy and antiangiogenic treatments. We have investigated the prognostic value of circulating endothelial cells and microparticles in patients treated for advanced non-small cell lung cancer.Methodology/Principal FindingsPeripheral blood samples were obtained from 60 patients before first line, platinum-based chemotherapy +/− bevacizumab, and after the third cycle of treatment. Blood samples from 60 healthy volunteers were also obtained as controls. Circulating endothelial cells were measured by an immunomagnetic technique and immunofluorescence microscopy. Phosphatidylserine-positive microparticles were evaluated by flow cytometry. Microparticle-mediated procoagulant activity was measured by the endogen thrombin generation assay. Results: pre- and posttreatment levels of markers were higher in patients than in controls (p<0.0001). Elevated levels of microparticles were associated with longer survival. Elevated pretreatment levels of circulating endothelial cells were associated with shorter survival.Conclusions/SignificanceCirculating levels of microparticles and circulating endothelial cells correlate with prognosis, and could be useful as prognostic markers in patients with advanced non-small cell lung cancer.

Cell-derived microparticles and the lung

“…After a multivariate regression analysis, these higher levels were an independent predictor of 1-year mortality. This result was clearly in contrast with the study by FLEITAS et al [59]. Moreover, in a previous study on the topic by the same investigators [61], both PMP and EMP levels were higher in 130 lung cancer patients compared with 30 healthy controls, but they were not associated with the presence of metastasis or with cancer stage (early versus advanced).…”

“…These have mostly focused on the possible prognostic value of microparticles in lung cancer but the results were discordant. FLEITAS et al [59] found higher levels of total circulating microparticles in 60 patients with nonsmall cell lung cancer compared with 60 controls, but the most relevant finding was that, in cancer patients, higher baseline levels of microparticles were associated with a better progression-free and overall survival. Discordant results emerged from another study conducted in 107 end-stage nonsmall cell lung cancer patients, divided into 1-year survivors and nonsurvivors, measuring PMPs and EMPs [60].…”

Quantification of circulating endothelial cells as a predictor of response to chemotherapy with platinum and pemetrexed in patients with advanced non-squamous non-small cell lung carcinoma

“…Finally, there is a Spanish work which also analyzes the role of CEC in NSCLC: Fleitas et al [23] determined the number of CEC in 60 patients with NSCLC by inmunomagnetic separation. No statistically significant association between baseline CEC levels and response was observed.…”

“…The results show significant differences as both predictive and prognostic factor in terms of response and survival [12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Membrane microparticles: shedding new light into cancer cell communication

“…Studies have also reported the presence of MPs in the plasma of cancer patients (Fleitas et al 2012;Savasan et al 2004;Toth et al 2008). Liebhardt et al (2010) analyzed the MPs in the plasma of breast cancer patients and identified four major subpopulations of MPs including a group positive for BCRP (BCRP + ).…”