Diagnostic Value of C-Veactive Protein and Vascular Endothelial Growth Factor in Differentiation of Pleural Effusions.
10.4046/trd.2003.55.5.467
- Author:
Sang Ha KIM
1
;
Won Yeon LEE
;
Joo Young PARK
;
Hyun Sook PARK
;
Hye Kyoung HAN
;
Hun Su JU
;
Tae Won HONG
;
Nak Won LEE
;
Kye Chul SHIN
;
Suk Joong YONG
Author Information
1. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. sjyong@wonju.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
C-reactive protein;
Vascular endothelial growth factor;
Pleural effusion;
Malignant
- MeSH:
Biopsy;
C-Reactive Protein;
Diagnosis;
Diagnostic Tests, Routine;
Exudates and Transudates;
Humans;
Immunoassay;
Pleural Effusion*;
Pleural Effusion, Malignant;
Prospective Studies;
Biomarkers, Tumor;
Vascular Endothelial Growth Factor A*
- From:Tuberculosis and Respiratory Diseases
2003;55(5):467-477
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Pleural effusions are generally divided into transudates and exudates. If it is exudative, more diagnostic tests are required in order to determine the cause of the local disease. A malignancy is a common and important cause of exudative pleural effusions. Because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions, several tumor markers have been examined. In order to overcome this limitation, this study hypothesized that C-reactive protein(CRP) and vascular endothelial growth factor(VEGF) measurements would be useful for differentiating trasudates from exudates and determining the differences between a benign and malignant effusion. METHODS: Eighty consecutive patients with a pleural effusion (tuberculous 20, parapneumonic 20, malignant 20, transudative 20) were examined prospectively: 60 of them were classified according to Light's criteria as having an exudative fluid and 20 had a transudative fluid. The standard parameters of a pleural effusion were examined and the serum and pleural effusion VEGF levels were measured using enzyme linked immunosorbent assay(ELISA). CRP in the serum and pleural fluid was determined by a turbidimetric immunoassay. RESULTS: The pleural CRP levels in the exudates were significantly higher than those in the transudates, 4.19+/-4.22 mg/dl and 1.29+/-1.45 mg/dl, respectively. The VEGF levels in the pleural effusions were significantly elevated in the exudates compared to the transudate, 1,011+/-1,055 pg/ml and 389+/-325 pg/ml, respectively. The VEGF ratio in the exudative effusion is significantly higher than a transudative effusions, 3.9+/-4.7 and 1.6+/-0.9, respectively. The pleural CRP levels in the patients with a benign effusion(4.15+/-4.20 mg/dl) were significantly higher than those in the malignant effusion(1.43+/-1.91 mg/dl). The VEGF ratio is significantly higher in malignant effusions(4.9+/-5.5) than in benign effusions(2.8+/-3.6). CONCLUSION: In conclusion, the CRP and VEGF levels in the serum and pleural effusion can distinguish between transudates and exudates. Moreover it can differentiate between benign and malignant pleural effusions.
