Decrease in circulating endothelial progenitor cells in treated glioma patients.

High-grade gliomas are highly vascularized tumors, in which the amount of new blood vessels is closely related with the degree of malignancy. The role of endothelial progenitor cells (EPCs) in the neoangiogenesis of gliomas and the effects of post-surgical therapies (i.e., radiotherapy (RT) and chemotherapy) have not yet been fully elucidated. The aim of the present study was to evaluate the effect of surgery and post-surgical treatment on the levels of circulating EPCs in glioma patients and their correlation with vascular endothelial growth factor (VEGF). In this study, we assessed by flow cytometry the number of EPCs in the peripheral blood of 78 high-grade glioma patients (both untreated and treated with RT and chemotherapy) and 34 age- and sex-matched healthy controls. EPCs were markedly decreased in all treated glioma patients as compared to untreated ones. VEGF levels were significantly higher in patients as compared to controls, and surgery, but not chemotherapy, significantly decreased VEGF concentrations. We found no relationship between VEGF plasma levels and EPCs. In conclusion, the reliability of EPCs as a biomarker for monitoring angiogenesis in glioma patients needs further studies of correlations of this parameter with other markers of tumor-related vasculature.