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Mohammadzadeh Lari S, Akbari A, Roustai Geraylow K, Zarifkia S, Hokmabadi F, Javidarabshahi Z, Nouri Daloee M, Hadizadeh Talasaz Z, Rafatpanah H, Akhlaghi S, Basiri R, Rezaee Talab F. Comparative Study of Vascular Endothelial Growth Factor in Exudative and Transudative Pleural Effusion. Tanaffos 2022; 21:384-390. [PMID: 37025317 PMCID: PMC10073953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 02/09/2022] [Indexed: 04/08/2023]
Abstract
Background 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. Materials and Methods 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. Results 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. Conclusion VEGF is assumed as an important factor in the pathogenesis of exudative PE, especially malignant effusion. It can distinguish between lymphocytic exudative PEs.
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Affiliation(s)
| | - Abolfazl Akbari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Shiva Zarifkia
- Student Research Committee, School of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran
| | - Farahnaz Hokmabadi
- Student Research Committee, School of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran
| | - Zahra Javidarabshahi
- Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Correspondence to: Javidarabshahi Z, Address: Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, Email address:
| | - Marzieh Nouri Daloee
- Department of Thoracic Surgery, Cardiothoracic Surgery and Transplant Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Houshang Rafatpanah
- Department Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Akhlaghi
- Department of Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Basiri
- Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fariba Rezaee Talab
- Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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