Study objectives: 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.
Design: The VEGF levels of consecutive patients undergoing
therapeutic thoracentesis were determined with an enzyme-linked
tertiary care center.
Results: 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.
Conclusions: 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