1. Improved diagnosis and prognostication of patients with pleural malignant mesothelioma using biomarkers in pleural effusions and peripheral blood samples – a short report
- Author
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Jaco Kraan, Stefan Sleijfer, Nick Beije, Ngoc M. Van, Robin Cornelissen, Michael A. den Bakker, John W.M. Martens, Cor van der Leest, Joachim G.J.V. Aerts, Alexander P.W.M. Maat, Medical Oncology, Pathology, Cardiothoracic Surgery, and Pulmonary Medicine
- Subjects
Male ,Mesothelioma ,0301 basic medicine ,Oncology ,Cancer Research ,Pathology ,Lung Neoplasms ,Pleural effusion ,Malignant pleural mesothelioma ,PLEURAL MALIGNANT MESOTHELIOMA ,Cohort Studies ,0302 clinical medicine ,Circulating tumor cell ,Aged, 80 and over ,medicine.diagnostic_test ,General Medicine ,Middle Aged ,Neoplastic Cells, Circulating ,Prognosis ,030220 oncology & carcinogenesis ,Molecular Medicine ,Female ,Adult ,medicine.medical_specialty ,Pleural Neoplasms ,CD146 Antigen ,Malignancy ,Polymorphism, Single Nucleotide ,Flow cytometry ,03 medical and health sciences ,Cell Line, Tumor ,Report ,Internal medicine ,Biomarkers, Tumor ,medicine ,Overall survival ,Humans ,Melanoma Cell Adhesion Molecule ,Aged ,business.industry ,Circulating tumor cells ,Tumor endothelial marker ,Endothelial Cells ,medicine.disease ,Peripheral blood ,030104 developmental biology ,business ,Circulating endothelial cells - Abstract
Purpose There is a lack of robust and clinically utilizable markers for the diagnosis and prognostication of malignant pleural mesothelioma (MPM). This research was aimed at optimizing and exploring novel approaches to improve the diagnosis and prognostication of MPM in pleural effusions and peripheral blood samples. Methods CellSearch-based and flow cytometry-based assays using melanoma cell adhesion molecule (MCAM) to identify circulating tumor cells (CTCs) in pleural effusions and peripheral blood samples of MPM patients were optimized, validated, explored clinically and, in case of pleural effusions, compared with cytological analyses. Additionally, tumor-associated circulating endothelial cells (CECs) were measured in peripheral blood samples. The assays were performed on a MPM cohort encompassing patients with histology-confirmed MPM (n=27) and in a control cohort of patients with alternative diagnoses (n=22). Exploratory analyses on the prognostic value of all assays were also performed. Results The malignancy of MCAM-positive cells in pleural effusions from MPM patients was confirmed. The detection of MPM CTCs in pleural effusions by CellSearch showed a poor specificity. The detection of MPM CTCs in pleural effusions by flow cytometry showed a superior sensitivity (48%) to standard cytological analysis (15%) (p = 0.03). In peripheral blood, CTCs were detected in 26% of the MPN patients, whereas in 42% of the MPM patients tumor-associated CECs were detected above the upper limit of normal (ULN). In exploratory analyses the absence of CTCs in pleural effusions, and tumor-associated CECs in peripheral blood samples above the ULN, appeared to be associated with a worse overall survival. Conclusion MCAM-based flow cytometric analysis of pleural effusions is more sensitive than routine cytological analysis. Flow cytometric analysis of pleural effusions and tumor-associated CECs in peripheral blood may serve as a promising approach for the prognostication of MPM patients and, therefore, warrants further study. Electronic supplementary material The online version of this article (doi:10.1007/s13402-017-0327-7) contains supplementary material, which is available to authorized users.
- Published
- 2017