Finding new indicators of disease outlook in non-small cell lung cancer

This study investigated whether the levels of certain cancer markers (CEC and soluble CD146) could predict the outcome for patients with non small cell lung cancer (NSCLC) undergoing surgery.

Markers for a disease are generally proteins which are detected at high levels in one group of patients. These markers can be used to diagnose the presence of a disease in patients, to predict the response to treatment, to predict the disease outlook and to evaluate the effectiveness of treatment.

In NSCLC, finding markers which can predict the outcome for patients may be useful in deciding whether there is a need for patients to undergo chemotherapy following surgery. Two markers have been shown to be higher in NSCLC patients – the level of circulating endothelial cells (CECs) and soluble CD416. Both of these markers are released into the blood in cancer patients. 

This study aimed to determine whether the levels of CEC and soluble CD146 in NSCLC patients were associated with disease outlook. This study involved 74 patients with NSCLC who had previously undergone surgery. 20 patients with small-cell lung cancer were also involved to determine whether the markers were specific to NSCLC patients rather than other types of lung cancer. A control group containing 20 patients with chronic obstructive pulmonary disease (COPD: smoker’s disease of the lung) was involved. A second control group of 42 non-smoking healthy individuals was also involved. 

Blood samples were taken from each participant immediately before surgery. The CEC count (number of cells per ml of blood) and soluble CD146 levels were measured.

The CEC count and soluble CD146 levels were significantly higher in NSCLC patients in comparison to COPD patients and healthy volunteers. A high CEC count and high levels of soluble CD146 were associated with a shorter survival in NSCLC patients. 

This study concluded that the CEC count and the level of sCD146 may be suitable markers for predicting the outcome of patients with NSCLC undergoing surgery. High levels of these markers may indicate the need for additional treatment. 

The study only assessed disease outlook after surgery. It might have been useful to also determine disease outlook following other treatments such as radiotherapy or chemotherapy.