Tumor Biology

, Volume 36, Issue 11, pp 9031–9037 | Cite as

Predictive and prognostic significance of circulating endothelial cells in advanced non-small cell lung cancer patients

  • Dong-mei Yuan
  • Qin Zhang
  • Yan-ling Lv
  • Xing-qun Ma
  • Yan Zhang
  • Hong-bing Liu
  • Yong Song
Research Article


The aim of this study was to evaluate the predictive and prognostic values of circulating endothelial cells (CECs) in patients with advanced non-small cell lung cancer (NSCLC). A total of 102 newly diagnosed advanced NSCLC patients were enrolled in this study. The amount of CECs was enumerated by flow cytometry (CD45− CD31+ CD146+) at baseline. CEC counts of 56 patients were detected before and after two cycles of chemotherapy. We correlated the baseline and reduction of CECs after therapy with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). The CEC level was significantly higher in advanced NSCLC patients, ranging from 57 to 1300 cells/105 cells (mean ± SD = 299 ± 221 cells/105 cells), than in patients with benign lesions (205 ± 97 cells/105 cells) and healthy volunteers (117 ± 33 cells/105 cells). When the cutoff value of CEC counts was 210 cells/105 cells, there was no significant association between CEC counts and OR/PFS/OS of the enrolled patients. However, patients with CEC response after chemotherapy have more chances to achieve OR (P < 0.001), and such patients showed longer PFS (P = 0.048) and OS (P = 0.018) than those without CEC response. In the multivariate analysis, the independent prognostic roles of brain metastasis (HR 6.165, P = 0.001), and CEC response (HR 0.442, P = 0.044) were found. The CEC counts could be considered as diagnostic biomarker for advanced NSCLC patients. And the reduction of CECs after treatment might be more ideal than the baseline CEC counts as a predictive or prognostic factor in patients treated with chemotherapy or anti-angiogenic therapy.


Circulating endothelial cells Non-small cell lung cancer Predictive factor Prognostic factor Anti-angiogenic therapy 


Conflict of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Dong-mei Yuan
    • 1
  • Qin Zhang
    • 2
  • Yan-ling Lv
    • 3
  • Xing-qun Ma
    • 1
  • Yan Zhang
    • 1
  • Hong-bing Liu
    • 1
  • Yong Song
    • 1
  1. 1.Department of Respiratory Medicine, Jinling HospitalNanjing University School of MedicineNanjingChina
  2. 2.Department of Gynecology, Jinling HospitalNanjing University School of MedicineNanjingChina
  3. 3.Nanjing Second Hospital affiliated to Medical CollegeSoutheast UniversityNanjingChina

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