Vascular Endothelial Growth Factor in Pleural Fluid

• Published in: Chest Vol. 116; no. 3; pp. 760 - 765
• Main Authors: Cheng, Dong-sheng, Rodriguez, R. Michael, Perkett, Elizabeth A., Rogers, Jeffrey, Bienvenu, Gary, Lappalainen, Urpo, Light, Richard W.
• Format: Journal Article
• Language: English
• Published: Northbrook, IL Elsevier Inc 01.09.1999; American College of Chest Physicians
• Subjects: Biological and medical sciences; Breast Neoplasms - metabolism; Coronary Artery Bypass; Coronary vessels; Dehydrogenases; Edema; Endothelial Growth Factors - analysis; Enzyme-Linked Immunosorbent Assay; Enzymes; Female; Heart failure; Heart Failure - metabolism; Heart surgery; Humans; Hypotheses; L-Lactate Dehydrogenase - analysis; Lung Neoplasms - metabolism; Lymphokines - analysis; malignant pleural effusion; Medical sciences; parapneumonic effusion; Patients; Permeability; Pleural effusion; Pleural Effusion - chemistry; Pleural Effusion - etiology; Pleural Effusion, Malignant - chemistry; Pneumology; Proteins; Proteins - analysis; Pulmonary Embolism - metabolism; Respiratory system : syndromes and miscellaneous diseases; Thoracentesis; Tumors; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors; Veins & arteries; malignant pleural effusion; LDH; parapneumonic effusion; vascular endothelial growth factor; VEGF; pleural effusion; CABG; Human; Vascular endothelium growth factor; Respiratory disease; Etiology; Pleurisy; Biological marker; Pleural disease; Exploration; Diagnosis; Pleural fluid; Comparative study
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.116.3.760

The purpose of this study was to analyze the relationship of the pleural fluid vascular endothelial growth factor (VEGF) level with the diagnostic category and with the pleural fluid characteristics in a group of 70 patients. The VEGF levels of consecutive patients undergoing therapeutic thoracentesis were determined with an enzyme-linked immunosorbent assay. University-affiliated tertiary care center. The median level of pleural fluid VEGF in the patients with congestive heart failure (150 pg/mL) was significantly (p < 0.05) lower than the median level in the patients with coronary artery bypass grafting (357 pg/mL), which in turn was significantly lower (p < 0.05) than the median levels in the patients with malignancy (1,097 pg/mL). The overlap between groups, however, limits the diagnostic usefulness of pleural fluid VEGF levels. The VEGF level was most closely correlated with the lactate dehydrogenase level (r = 0.42, p < 0.001) and was also significantly correlated with the total pleural fluid protein level. The median VEGF levels in the pleural fluid of patients with breast cancer were significantly lower (p = 0.017) than in those with lung cancer. The VEGF level was very high (3,294 pg/mL) in the one patient with pulmonary embolism. We conclude that the VEGF levels in pleural fluid differ significantly from one diagnostic category to another with the highest median levels occurring in patients with malignant pleural effusions. We speculate that VEGF may be responsible for the pleural fluid accumulation in at least some situations.