Comparison of Vascular Endothelial Growth Factor-A (VEGF-A) Level in Pleural Fluid of Patients with Malignant and Nonmalignant Pleural Effusion

Abstract

Malignant pleural effusion (PE) is a complication that often occurs in advanced cancer. The sensitivity of pleural fluid cytology is reported to vary from 30 to 90%; therefore, the process is less clinically practical in certain conditions. Thus, special biomarkers are needed to distinguish malignant PE and nonmalignant PE. The aim of this study is to compare the level of vascular endothelial growth factor-A (VEGF-A) in pleural fluid of patients with that in malignant and nonmalignant PE. Participants were divided into 2 groups: 19 patients with nonmalignant PE, and 34 patients with malignant PE. Both groups underwent pleural puncture procedures and were examined for VEGF-A levels. Statistical analysis was performed using the paired test or Mann–Whitney test. The ROC curve was employed to determine the VEGF-A cut-off value in malignant PE. The VEGF-A level in pleural fluid of malignant PE group was 1940.77 ± 1016.54 pg/mL, while the nonmalignant group was 178.16 ± 192.01 pg/mL (p < 0.001; 95% CI). The average VEGF-A level in malignant PE group with positive anatomic pathology results was 2036.69 ± 1008.15 pg/mL, and negative was 1855.51 ± 1045.35 pg/mL (p = 0.612; 95% CI). The cutoff value for VEGF-A level in pleural fluid for the diagnosis of malignant PE was 416.60 pg/mL with a sensitivity and specificity of 85.29% and 84.22% respectively. Examination of VEGF-A level in pleural fluid can be considered as a means of supporting the diagnosis of malignant PE.