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.
All Science Journal Classification (ASJC) codes
- Pulmonary and Respiratory Medicine
- Infectious Diseases