TY - JOUR T1 - Predictive value of pro-inflammatory cytokine and pro-angiogenic factor in differentiating malignant from benign exudative effusion JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2783 AU - Radwa Elhefny AU - Marwa Shaban AU - Olfat Shaker Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2783.abstract N2 - The precise pathogenetic mechanisms of exudative effusions are still unsettled. Incremented permeability of the pleural microvasculature is attributed to factors that are released in inflammatory and malignant pleural diseases. Angiopoietin 2 (Ang-2) plays an essential role in angiogenesis and takes part in pleural inflammation. Interleukin-8(IL-8) influences proliferation and tumor angiogenesis. Objective: to investigate the relationship between inflammation, angiogenesis and etiologies of exudative effusions and its diagnostic value in differentiating malignant from benign effusion. Methods: the study includes 49 pleural fluid (PF) samples. PF and serum Ang-2, IL-8 levels were estimated. Results: ten patients had transudative and 39 patients had exudative effusions, subdivided into 16 benign and 23 malignant effusion. Both PF Ang-2 and IL-8 levels; and pleural fluid / serum ratio of Ang-2 and IL-8 were significantly higher in exudates than in transudates. PF Ang-2 and IL-8 levels were higher than serum Ang-2 level in both exudates and transudates. Both PF Ang-2 level and pleural fluid/serum ratio were significantly higher in benign than in malignant exudates while PF IL8-level was significantly higher in malignant than in benign exudates. Cut-off points for PF Ang-2 and PF IL8 in differentiating malignant from benign exudates were 15.67 ng/ml and 325.54 pg/ml respectively. Conclusion: our results support the evidence that both angiogenesis and inflammatory pathways are closely linked and that pleural inflammation and vascular permeability constitute the patho-genetic basis of the vast majority of exudative effusion. ER -