Zhu Ying-Ying, Wu Hui-Mei, Liu Rong-Yu
Clin Lab. 2017 Sep 1;63(9):1371-1378. doi: 10.7754/Clin.Lab.2017.170217.
The diagnosis of malignant pleural effusion (MPE) remains a common clinical challenge because of the sensitivity of conventional cytology for the detection is insufficient. Thus, a sensitive clinical marker for diagnosis is required. The aim of this study was to assess the role of two anti-angiogenic cytokines, soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and endostatin, in diagnosing MPE.
Effusion samples from 44 patients with MPE caused by lung cancer and from 36 patients with benign pleural effusion (BPE) were collected. The concentrations of sVEGFR-1 and endostatin in pleural fluid were determined by an enzyme-linked immunosorbent assay (ELISA). The diagnostic performance was measured by receiver operating characteristic curves (ROCs).
The levels of sVEGFR-1 and endostatin in MPE due to lung cancer were significantly higher than those in BPE (p < 0.05). The sensitivity and specificity of endostatin were 52.27% and 86.11%, respectively, while for sVEGFR-1, the sensitivity was 88.64% and the specificity was 58.33%. Interestingly, the combination of sVEGFR1 and endostatin produced better sensitivity and specificity of 72.73% and 83.33%, respectively. In addition, the levels of sVEGFR-1 and endostatin were significantly related to each other (p < 0.05), and the levels of endostatin in bloody effusions were significantly higher than those in non-bloody effusions (p < 0.05).
Our study indicated that the levels of sVEGFR-1 and endostatin were significantly elevated in MPE. The combined detection of sVEGFR-1 and endostatin may be useful in the diagnosis of MPE.
由于传统细胞学检测恶性胸腔积液（MPE）的敏感性不足，其诊断仍是一项常见的临床挑战。因此，需要一种敏感的诊断临床标志物。本研究的目的是评估两种抗血管生成细胞因子，可溶性血管内皮生长因子受体-1（sVEGFR-1）和内皮抑素在MPE诊断中的作用。
收集44例肺癌所致MPE患者和36例良性胸腔积液（BPE）患者的胸水样本。采用酶联免疫吸附测定（ELISA）法测定胸水中sVEGFR-1和内皮抑素的浓度。通过受试者工作特征曲线（ROC）评估诊断性能。
肺癌所致MPE中sVEGFR-1和内皮抑素水平显著高于BPE（p<0.05）。内皮抑素的敏感性和特异性分别为52.27%和86.11%，而sVEGFR-1的敏感性为88.64%，特异性为58.33%。有趣的是，sVEGFR1和内皮抑素联合检测的敏感性和特异性更好，分别为72.73%和83.33%。此外，sVEGFR-1和内皮抑素水平显著相关（p<0.05），血性胸水中内皮抑素水平显著高于非血性胸水（p<0.05）。
我们的研究表明，MPE中sVEGFR-1和内皮抑素水平显著升高。sVEGFR-1和内皮抑素联合检测可能有助于MPE的诊断。
