Circulating tumor cells as a diagnostic test for malignant pleural mesothelioma

Our plain-English summary of Circulating tumor cells as a diagnostic test for malignant pleural mesothelioma, by G. Pinton, A.G. Manente, L. Moro, et al (Expert Opinion on Medical Diagnostics, 2012).

The study

• Authors: G. Pinton, A.G. Manente, L. Moro, L. Mutti
• Journal: Expert Opinion on Medical Diagnostics
• Published: 2012;6(3):171-3
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The detection of circulating tumor cells (CTCs) may have important prognostic and therapeutic implications; therefore, we expect a broader range of tumor types in which CTC detection and count will routinely be conducted in the coming years. This article evaluates the application of CTC as a potentially useful diagnostic and prognostic test in malignant pleural mesothelioma (MMe). MMe is a rare but increasingly prevalent, highly aggressive asbestos exposure-related tumor. MMe develops after long time latency, is rarely diagnosed at early stages, is poorly sensitive to conventional treatments and presents a very short survival upon diagnosis. Pursuing research of CTC in MMe can represent a very important task for all the clinical and preclinical scientists working on blood biomarkers of this tumor. Possibly in combination with other diagnostic tools, such as a thoracoscopy and advanced imaging, CTC can represent a promising tool for MMe prognosis and follow-up. Further studies to confirm value of CTC test in MMe are warranted.

In plain English

This article was an editorial, not an original study, and it reported no new patient data. The authors discussed whether circulating tumor cells (CTCs), meaning tumor cells found in the blood, could help diagnose and follow malignant pleural mesothelioma (MMe), which they described as an asbestos exposure-related tumor. They summarized limited data from two research groups. In a small case series by Wendell and colleagues, CTCs were found in six of eight MMe patients at diagnosis and in all eight during the course of the disease. In a study by Tanaka and colleagues, CTCs were found in the blood of 28% of MMe patients and 47% of lung cancer patients, and in no patient with nonmalignant disease. In a later study of 170 cases by the same group, the CTC test did not show significant diagnostic performance in telling MMe apart from nonmalignant disease. In that study its sensitivity was 28% and its specificity 91%. The authors concluded that CTCs could be a promising tool for MMe prognosis and follow-up, possibly alongside other tools, and that further studies were warranted.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Editorial discussing published studies (no original data)
• Who was studied: No patients were studied directly. The editorial discussed limited data from two research groups (Wendell et al. and Tanaka et al.) on CTCs in malignant pleural mesothelioma patients.
• Exposure: No exposure was studied. The authors described malignant pleural mesothelioma as asbestos exposure-related and named no fiber types.
• Main results:
  • Reported from Wendell et al. (eight non-sarcomatoid MMe patients): CTCs were present in six of eight patients at diagnosis and in eight of eight (100%) during the disease course.
  • Reported from Tanaka et al. (36 MMe and 34 primary lung cancer patients): CTCs in peripheral blood were positive in 28% of MMe and 47% of lung cancer patients, and were not detected in any patient with nonmalignant disease.
  • Reported from Tanaka et al.: the CTC number and the percentage of CTC-positive patients tended to rise with tumor stage, but the difference was not statistically significant in MMe or lung cancer.
  • Reported from a later study by the same group (170 eligible cases: 137 MMe, 33 nonmalignant disease): CTC count was significantly higher in MMe, but ROC analysis failed to show a significant diagnostic performance in distinguishing MMe from nonmalignant disease. Sensitivity was 28% and specificity 91%.
  • Same later study: the CTC test was reported positive in 38% of MMe cases and in 9% of nonmalignant cases.
• The authors' conclusion: The authors concluded that research on CTCs in MMe should be pursued, possibly in combination with other modalities such as thoracoscopy and advanced imaging, that CTCs could be a promising tool for MMe prognosis and follow-up, and that further studies were warranted.
• Limitations the authors state:
  • The authors noted that only limited data from two research groups were available on CTCs in MMe.
  • The authors noted that the Wendell et al. series was small, so further studies are needed to clarify the link between CTC kinetics and outcome.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Asbestos Exposure, Latency, Biomarker, Thoracoscopy, Prognosis.

Related studies

• Circulating endothelial cell (CEC) as a diagnostic and prognostic marker in malignant pleural mesothelioma (MPM) — K. Yoneda, F. Tanaka, et al. (2012)
• EpCAM-independent capture of circulating tumor cells with a 'universal CTC-chip' — Y. Chikaishi, K. Yoneda, et al. (2017)
• Detection of Circulating Tumor Cells (CTCs) in Malignant Pleural Mesothelioma (MPM) with the "Universal" CTC-Chip and An Anti-Podoplanin Antibody NZ-1.2 — T. Kuwata, K. Yoneda, et al. (2020)
• Detection of circulating tumor cells with a novel microfluidic system in malignant pleural mesothelioma — K. Yoneda, T. Kuwata, et al. (2019)
• Circulating tumor cells (CTCs) in malignant pleural mesothelioma (MPM) — K. Yoneda, F. Tanaka, et al. (2014)
• Tumor-specific genetic variants can be detected in circulating cell-free DNA of malignant pleural mesothelioma patients — M. Hylebos, K. Op de Beeck, et al. (2018)

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