Mohammadzadeh Lari Shahrzad, Akbari Abolfazl, Roustai Geraylow Kiarash, Zarifkia Shiva, Hokmabadi Farahnaz, Javidarabshahi Zahra, Nouri Daloee Marzieh, Hadizadeh Talasaz Zahra, Rafatpanah Houshang, Akhlaghi Saeed, Basiri Reza, Rezaee Talab Fariba
Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Tanaffos. 2022 Mar;21(3):384-390.
Increased vascular permeability is one of the main mechanisms in the production of pleural effusion (PE) and vascular endothelial growth factor (VEGF) has a significant role in its pathogenesis. This study aimed to compare pleural levels of VEGF in transudative and exudative PEs besides the other pleural markers.
In this prospective cross-sectional study, 80 patients with PE were divided into 4 groups as transudative (N=15), parapneumonic (N=15), tuberculosis (N=25), and malignant (N=25) PE. Biochemical tests measured the pleural protein, LDH, cholesterol, glucose, polymorphonuclear cell (PMN), and lymphocyte. ELISA measured the pleural VEGF level.
Out of 80 patients, 51 were male, and the total mean age was 55.34±18.53. There were significant differences in pleural VEGF between exudative and transudative effusion (P<0.001) and between malignant and benign effusion (P=0.014). The highest mean difference in pleural VEGF levels was seen in the comparison of transudative and malignant groups (Mean difference=-136.56; P<0.002). The VEGF level in 3 groups was not significantly different; transudative vs tuberculous, parapneumonic vs tuberculous, and parapneumonic vs malignant. Furthermore, VEGF higher than 73.09 pg/ml had a 64% sensitivity and 82% specificity for the diagnosis of malignancy. Among pleural markers (VEGF, protein, LDH, and glucose), VEGF had the highest area under curve (AUC=0.734). Moreover, pleural protein, LDH, and glucose levels significantly correlated with pleural VEGF; however, pleural cholesterol, PMN, and lymphocyte were not correlated.
VEGF is assumed as an important factor in the pathogenesis of exudative PE, especially malignant effusion. It can distinguish between lymphocytic exudative PEs.
血管通透性增加是胸腔积液(PE)产生的主要机制之一,血管内皮生长因子(VEGF)在其发病机制中起重要作用。本研究旨在比较漏出性和渗出性胸腔积液中VEGF的胸腔水平以及其他胸腔标志物。
在这项前瞻性横断面研究中,80例胸腔积液患者被分为4组,即漏出性(N = 15)、类肺炎性(N = 15)、结核性(N = 25)和恶性(N = 25)胸腔积液。生化检测测量胸腔蛋白、乳酸脱氢酶(LDH)、胆固醇、葡萄糖、多形核细胞(PMN)和淋巴细胞。酶联免疫吸附测定(ELISA)测量胸腔VEGF水平。
80例患者中,51例为男性,总平均年龄为55.34±18.53。渗出性和漏出性胸腔积液之间以及恶性和良性胸腔积液之间胸腔VEGF存在显著差异(P < 0.001和P = 0.014)。胸腔VEGF水平的最大平均差异出现在漏出性和恶性组的比较中(平均差异=-136.56;P < 0.002)。3组之间的VEGF水平无显著差异;漏出性与结核性、类肺炎性与结核性、类肺炎性与恶性之间。此外,VEGF高于73.09 pg/ml对恶性肿瘤诊断的敏感性为64%,特异性为82%。在胸腔标志物(VEGF、蛋白、LDH和葡萄糖)中,VEGF的曲线下面积最大(AUC = 0.734)。此外,胸腔蛋白、LDH和葡萄糖水平与胸腔VEGF显著相关;然而,胸腔胆固醇、PMN和淋巴细胞无相关性。
VEGF被认为是渗出性胸腔积液尤其是恶性胸腔积液发病机制中的一个重要因素。它可以区分淋巴细胞性渗出性胸腔积液。