Abstract. The aims of the present study were to establish a single-platform f low cytometry method using 5-(and 6)-carboxyfluorescein diacetate succinimidyl ester (CFSE)-labeled microspheres as the reference for determining endothelial progenitor cell (EPC) number and to evaluate the efficacy of this detection method. Single-platform flow cytometry was used to count cell numbers using CFSE-stained fluorescent microspheres as the internal reference and the EPC numbers in specimens using this novel method were compared with an in vitro clonogenic counting assay. The results of the two counting methods were consistent and compared with the in vitro clonogenic counting assay, the time and cost of the novel method was markedly reduced, as were the corresponding technical requirements. The present findings indicated that single-platform flow cytometry, with CFSE-labeled microspheres as the reference, provides faster and improved detection of EPCs in human peripheral blood specimens, with reduced time and cost, making it more suitable for routine clinical application.
IntroductionThe occurrence, development and metastasis of tumors are closely related to angiogenesis due to the fact that blood vessels provide the necessary oxygen supply, nutrition, metabolite and avenue for metastasis to maintain the rapid growth of tumors (1-3). Angiogenesis, which is the generation of novel blood vessels, occurs by two completely different processes (4-6). In the first, the required vascular endothelial cells arise from the sprouting of existing blood vessels. In the second, they are derived from recruited endothelial precursor cells, which are a type of blast cell with the potential to differentiate into clonal endothelial cells in vitro as well as participate in cardiovascular generation in vivo (7). On their surface, they characteristically express cluster of differentiation (CD)34, vascular endothelial growth factor receptor 2 (VEGFR2) or kinase domain receptor (8,9).A large number of basic and clinical studies have indicated that the number of endothelial progenitor cells (EPCs) is closely related to tumor size, prognosis and therapy response (10-13). Evidence from animal models suggests that the EPC level in the peripheral circulation has some relevance to tumor volume (13). The number of EPCs in circulation has been identified to alter with anti-tumor and anti-angiogenesis therapies. Igreja et al (14) suggested that the EPC level in the peripheral blood of patients with lymphoma was related to the efficacy of the therapy. This hypothesis was supported by the fact that the EPC level in patients with complete remission decreased, while EPC levels continued to rise or did not change in those with partial remission or no response to therapy. In addition, it was revealed that tumor size and angiogenesis were associated with the number of EPCs in lymph nodes. Ho et al (15) indicated that, in patients with advanced non-surgically treated hepatocellular carcinoma (HCC), the EPC level in circulation was significantly higher compared w...