The purpose of the study was to evaluate predictive value of vascular endothelial growth factor (VEGF) in the differential diagnosis of pleural effusion.
Material and methods: By Light's criteria in 29 cases exudates and 10 transudates was recognized. We investigated 39 patients with pleural effusion (congestive heart failure--10, parapneumonic--11, tuberculous--6, malignant--12, transudate--10).
Results: The mean VEGF value were significantly higher (p = 0.002) in the effusion of lung cancer patient (3958.33 pg/ml) than in the serum (1030.33 pg/ml). The mean VEGF levels were significantly higher (p = 0.004) in patient with exudates (2711.10 pg/ml) than in transudates (683 pg/ml). Based on the receiver operating characteristic (ROC) curve analysis, cut off value in differentiation of exudates and transudates was accepted at the level of 560 pg/ml (sensitivity 80% and specificity 70%). The mean VEGF levels were significantly higher (p = 0.008) in the malignant effusion (3958.33 pg/ml) than in the tuberculous effusion (1308.90 pg/ml). Based on the ROC curve analysis, cut off value in differentiation of malignant and tuberculous effusion was accepted at the level of 2000 pg/ml (sensitivity 92% and specificity 83%). The positive correlation between pleural VEGF concentrations and pleural lactate dehydrogenase (LDH) level were observed (r = 0.67, p < 0.05).
Conclusion: We conclude that pleural effusion VEGF level could be useful in the differentiation between exudates and transudate and also between malignant and tuberculous exudates.