Vascular endothelial growth factor in diagnosis of pleural effusion

Abstract

Background: Vascular endothelial growth factor (VEGF) is a glycoprotein which is an important mediator of angiogenesis and vascular permeability. Different VEGF levels were found in carcinomatous, inflammatory and tuberculous pleural effusions, implying a varying degree of influence on the process of fluid accumulation in the pleural space in different disease states. Aim of the work: to assess the role of serum and pleural fluid VEGF levels to evaluate its value as a marker in diagnosis of pleural effusion of different etiologies. Methods: Forty patients with pleural effusion, 19 males and 21 females, with a mean age of 55.960 ± 6.835 years, were classified into transudative and exudative groups. All patients were subjected to thorough history, clinical examination, radiological examination, laboratory investigations, sputum for acid fast bacilli, tuberculin test, thoracocentesis and occasionally pleural biopsy or thoracoscopy and both serum and pleural fluid VEGF were measured in all patients. Results: There was a significant difference between exudate and transudate regarding serum and pleural fluid VEGF levels that were higher in exudates than transudate. In comparison between the subtypes of exudative effusion, there was higher concentration of VEGF in pleural of malignant than tuberculous, parapneumonic, and collagen exudative effusion. Conclusion: VEGF pleural fluid level could differentiate between malignant and non malignant effusion, while could not differentiate between tuberculous and nontuberculous, or between parapneumonic and nonparapneumonic exudative effusions.