Abstract
22126 Background: Mayo data revealed that the median survival of patients with malignant pleural effusion is 4.7 months, with a 23% survival at one year and 7% at two years. These data emphasize the need for more preclinical research on ways to improve the diagnosis and treatment of malignant effusions. The purpose of this double-blind study was to ascertain VEGF A, C and D levels in various fresh pleural effusions. Methods: Sixty-four patients with cytology-known recurrent pleural effusions, who either underwent ultrasound-guided thoracentesis or fluid removal at the time of PleurX catheter placement. The effusions were centrifuged, aliquoted and frozen within 24 hours after removal. Each sample was evaluated for VEGF A, C and D levels using assay kits from ELISA-DuoSet by R&D in Minneapolis, MN. Results: Twenty-four non-malignant effusions and 40 malignant effusions including lung (15), breast (5), GI (6), ovarian (3), renal cell (3) and hematologic (8) were assayed. Assay findings (log transformed) were compared across groups using analysis of variance (ANOVA) with Dunnett's test used to compare each group to the non-malignant controls. Compared to controls (median VEGF A = 177), malignant effusions from adenocarcinomas had significantly elevated VEGF A with highest levels seen in renal cell carcinoma (median 6643), ovarian (median 4534), GI (median 4506), lung (median 3403) and breast (median 1577). Hematologic malignancies had low levels of VEGF A (median 107). Levels of VEGF C and D did not differ significantly across groups. Conclusions: Elevated levels of VEGF A in malignant effusions from adenocarcinomas may allow the use of the PleurX catheter as a means to treat and assess response to intracavitary antiangiogenesis therapies. No significant financial relationships to disclose.
Published Version
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