Meta-Analysis of Circulating Endothelial Cells and Circulating Endothelial Progenitor Cells as Prognostic Factors in Lung Cancer


Background: The aim of this study was to analyze the prognostic implications of pretreatment circulatingendothelial cells (CECs) and circulating endothelial progenitor cells (CEPCs) for the survival of patients withlung cancer. Materials and
Methods: Relevant literature was identified using Medline and EMBASE. Patientclinical characteristics, overall survival (OS) and progression-free survival (PFS) together with CEC andCEPC positive rates before treatment were extracted. STATA 12.0 was used for our analysis and assessment ofpublication bias.
Results: A total of 13 articles (8 for CEC and 5 for CEPC, n=595 and n=244) were pooled forthe global meta-analysis. The odds ratio (OR) for OS predicted by pretreatment CECs was 1.641 [0.967, 2.786],while the OR for PFS was 1.168 [0.649, 2.100]. The OR for OS predicted by pretreatment CEPCs was 12.673[5.274, 30.450], while the OR for PFS was 4.930 [0.931, 26.096]. Subgroup analyses were conducted accordingto clinical staging. Odds ratio (OR) showed the high level of pretreatment CECs only correlated with the OSof patients with advanced lung cancer (stage III-IV).
Conclusions: High counts of CECs seem to be associatedonly with worse 1-year OS in patients with lung cancer, while high level of pretreatment CEPCs correlate withboth worse PFS and OS.