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1 Institute of Clinical Immunology and Transfusion Medicine, and 2 Medical Dept, Pulmonary and Intensive Care Unit, University of Leipzig, and 5 Robert Koch Hospital, Leipzig, Germany. 3 Respiratory and Palliative Care Unit, Haven of Hope Hospital, and 4 Dept of Medicine and Therapeutics, Respiratory Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
CORRESPONDENCE: U. Sack, University of Leipzig, Institute of Clinical Immunology and Transfusion Medicine, Johannisallee 30, 04103 Leipzig, Germany. Fax: 49 3419725828. E-mail: ulrich.sack@medizin.uni-leipzig.de
Keywords: Pleural effusion, receiver-operating characteristic analysis, serum, vascular endothelial growth factor
Received: March 30, 2004
Accepted November 30, 2004
This study aimed to determine the diagnostic relevance of vascular endothelial growth factor (VEGF) in the pleural fluid and serum of patients with pleural effusions of different aetiology.
VEGF was quantified in the pleural effusion fluid and serum of 96 patients with malignancies (58 lung cancers (CA) and 38 tumours with secondaries to the lung (TM)), 45 with congestive heart failure (CHF), 28 with tuberculosis (TB), 45 with acute infections (INF), and in the serum of 20 healthy controls.
VEGF pleural effusion concentrations were significantly different in the main diagnostic groups. VEGF was higher in effusions of patients with malignancies (CA as well as TM) in comparison with INF, TB or CHF. In serum, however, high VEGF concentrations indicated CA, TM or INF, but not TB or CHF. Despite significant differences of VEGF levels in different patient groups, receiver-operating characteristic analysis revealed insufficient diagnostic value of VEGF for differential diagnosis of pleural effusions.
In conclusion, vascular endothelial growth factor serum concentration is highly suggestive of the presence of lung disease in general, except for tuberculosis. In effusion fluid, the presence of vascular endothelial growth factor clearly indicates inflammatory or malignant origin. However, for diagnostic use, additional parameters besides vascular endothelial growth factor are mandatory.
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