RT Journal Article
SR Electronic
T1 1,25-dihydroxyvitamin D in malignant and non-malignant pleural effusions
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3080
VO 42
IS Suppl 57
A1 Marios Panagiotou
A1 Andriana I. Papaioannou
A1 Filia Diamantea
A1 Styliani Giannakaki
A1 Elvira Markela Antonogiannaki
A1 Sofia Pouriki
A1 Alexandros Kalkanis
A1 Anna Takou
A1 George D. Maropoulos
A1 Emmanuel Kastanakis
A1 Vlassios Polychronopoulos
A1 Konstantinos Kostikas
A1 Napoleon Karagianidis
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3080.abstract
AB Background:Vitamin D (VitD) is a key modulator of host immune response and is raised in patients with lung cancer. However, there are no studies evaluating the levels of VitD in malignant pleural effusions.Objectives:To evaluate the diagnostic role of VitD levels in pleural effusions of various etiologies.Methods:Prospective study of consecutive patients with a new diagnosis of pleural effusion. Exclusion criteria included previous diagnostic/therapeutic attempts or no definite diagnosis after at least 6-month follow up. Pleural fluid and serum samples were collected, protected from light exposure and immediately stored in -20°C until testing for VitD with Chemiluminescent Immunoassay.Results:Fifty patients were studied. Pleural VitD was higher than serum VitD(p<0.001). Pleural VitD did not differ between exudates and transudates(p=0.31) but was significantly higher in malignant compared to benign effusions (p=0.037). VitD levels > 11.6 ng/ml were diagnostic for malignant effusions (Sensitivity=68%,Specificity=73%,PPV=81%,NPV=58%). Malignant effusions with positive cytology had higher levels of VitD than those with negative cytology (p=0.007). Pleural VitD did not differ between effusions caused by lung cancer versus non-lung cancer (p=0.72). VitD levels in malignant effusions above the upper quartile (i.e. 24.5 ng/ml) were related to better survival during the 6-month follow up compared to lower levels (p<0.001,log rank test).Conclusions:Malignant pleural effusions present increased levels of VitD and higher levels of pleural VitD were associated to positive cytology, plausibly reflecting a greater local immune response. Increased levels of VitD were associated with better survival in this small population.