Published in:
01-12-2014 | Translational Research and Biomarkers
Circulating Tumor Cells (CTCs) in Malignant Pleural Mesothelioma (MPM)
Authors:
Kazue Yoneda, PhD, Fumihiro Tanaka, MD, PhD, Nobuyuki Kondo, MD, PhD, Masaki Hashimoto, MD, Teruhisa Takuwa, MD, Seiji Matsumoto, MD, PhD, Yoshitomo Okumura, MD, PhD, Noriaki Tsubota, MD, PhD, Ayuko Sato, PhD, Tohru Tsujimura, MD, PhD, Kozo Kuribayashi, MD, PhD, Kazuya Fukuoka, MD, PhD, Chiharu Tabata, MD, PhD, Takashi Nakano, MD, PhD, Seiki Hasegawa, MD, PhD
Published in:
Annals of Surgical Oncology
|
Special Issue 4/2014
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Abstract
Purpose
To investigate the diagnostic and prognostic value of circulating tumor cells (CTCs), a potential surrogate of micrometastasis, in malignant pleural mesothelioma (MPM).
Methods
We prospectively evaluated CTCs in 7.5 mL of peripheral blood sampled from patients with a suspicion of MPM. A semiautomated system was used to capture CTCs with an antibody against the epithelial cell adhesion molecule.
Results
Of 136 eligible patients, 32 were finally diagnosed with nonmalignant diseases (NM), and 104 had MPM. CTCs were detected in 32.7 % (34 of 104) of MPM patients but in only 9.4 % (3 of 32) of NM patients (P = 0.011). The CTC count was significantly higher in MPM patients than in NM patients (P = 0.007), and a receiver operating characteristic (ROC) curve analysis showed an insufficient capability of the CTC test in discrimination between MPM and NM, with an area under ROC curve of 0.623 (95 % confidence interval, 0.523–0.723; P = 0.036). Among MPM patients, CTCs were more frequently detected in patients with epithelioid subtype (39.7 %, 31 of 78) than in those with nonepithelioid subtypes (11.5 %, 3 of 26; P = 0.016). Positive CTCs (CTC count ≥1) were a significant factor to predict a poor prognosis among epithelioid patients (median overall survival, 22.3 months for positive CTCs vs. 12.6 months for negative CTCs; P = 0.004) and not in nonepithelioid patients (P = 0.649). A multivariate analysis showed that positive CTCs were a significant and independent factor to predict a poor prognosis (hazard ratio, 2.904; 95 % confidence interval, 1.530–5.511; P = 0.001) for epithelioid MPM patients.
Conclusions
CTC was a promising marker in diagnosis and prediction of prognosis in MPM, especially in epithelioid MPM.