Sir,
In their interesting study Wong et al (2012) report a preclinical and clinical correlation between the number of CD45−CD31+ cells in the peripheral blood and the growth of prostate cancer. Using flow cytometry and microscopy, they suggest that the large majority of CD45−CD31+ cells are more likely immature platelets and not circulating endothelial cells (CECs). Considering the wide antigenic overlap between CECs and platelets, and the possible aggregation/adhesion of platelets with CECs, we and others feel that in multiparametric flow cytometry the use of a cell viability stain and of a DNA-specific staining are necessary to discriminate DNA-containing CECs from DNA-free, CEC-derived macroparticles and platelets (Bertolini et al, 2006; Mancuso and Bertolini, 2010; Mund et al, 2012).
When Ning et al (2010) used a nucleic acid stain to enumerate CECs in prostate cancer patients receiving Bevacizumab, Docetaxel, Thalidomide and Predinisone, they reported a strong inverse correlation between changes in apoptotic CECs and PSA levels, suggesting that the drug combination may effectively inhibit tumour angiogenesis. Along this line, Strijbos et al (2010) used a nuclear stain to enumerate CECs in prostate cancer patients receiving Docetaxel. They reported that CECs’ kinetics during treatment, alone or in combination with other biomarkers, predicted survival in this cancer population.
Data from Wong et al (2012) suggest that immature platelets deserve further clinical investigation as possible biomarkers of disease status in metastatic prostate cancer. One of the unique features of multiparametric flow cytometry is the possibility to enumerate in the same test-tube several different populations of cells, such as DNA-containing CECs, DNA-free, CEC-derived macroparticles and platelets. Several previous clinical studies involving antiangiogenic therapeutics in cancer patients indicated that these different cell and platelet populations might serve as unique predictive and/or prognostic biomarkers. We, therefore, recommend investigating them all in parallel in one test-tube using multiparametric flow cytometry technique.
Change history
02 April 2013
This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication
References
Bertolini F, Shaked Y, Mancuso P, Kerbel RS (2006) The multifaceted circulating endothelial cell in cancer: from promiscuity to surrogate marker and target identification. Nat Reviews Cancer 6 (11): 835–845
Mancuso P, Bertolini F (2010) Circulating endothelial cells as biomarkers in clinical oncology. Microvascular Res 79 (3): 224–228
Mund JA, Estes ML, Yoder MC, Ingram DA, Case J (2012) Flow cytometric identification and functional characterization of immature and mature circulating endothelial cells. Arterioscler Thromb Vasc Biol 32 (4): 1045–1053
Ning YM, Gulley JL, Arlen PM, Woo S, Steinberg SM, Wright JJ, Parnes HL, Trepel JB, Lee MJ, Kim YS, Sun H, Madan RA, Latham L, Jones E, Chen CC, Figg WD, Dahut WL (2010) Phase II trial of bevacizumab, thalidomide, docetaxel, and prednisone in patients with metastatic castration-resistant prostate cancer. J Clin Oncol 28 (12): 2070–2076
Strijbos MH, Gratama JW, Schmitz PI, Rao C, Onstenk W, Doyle GV, Miller MC, de Wit R, Terstappen LW, Sleijfer S (2010) Circulating endothelial cells, circulating tumour cells, tissue factor, endothelin-1 and overall survival in prostate cancer patients treated with docetaxel. Eur J Cancer 46 (11): 2027–2035
Wong CKE, Namdarian B, Chua J, Chin X, Speirs R, Nguyen T, Fankhauser M, Pedersen J, Costello AJ, Corcoran NM, Hovens CM (2012) Levels of a subpopulation of platelets, but not circulating endothelial cells, predict early treatment failure in prostate cancer patients after prostatectomy. Br J Cancer 107 (9): 1564–1573
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
About this article
Cite this article
Bertolini, F., Shaked, Y. & Mancuso, P. On the clinical relevance of circulating endothelial cells and platelets in prostate cancer. Br J Cancer 108, 1387 (2013). https://doi.org/10.1038/bjc.2012.528
Published:
Issue Date:
DOI: https://doi.org/10.1038/bjc.2012.528
This article is cited by
-
Reply: On the clinical relevance of circulating endothelial cells and platelets in prostate cancer
British Journal of Cancer (2013)