Vascular endothelial growth factor in pleural fluid

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 anti with the plural fluid characteristics in a group of 70 patients, Design: The VEGF levels of consecutive patients undergoing therapeutic thoracentesis were determined with an enzyme-linked immunosorbent assay, Setting: University-affiliated 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) lon er 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 hct between groups, hen-ever, limits the diagnostic usefulness of pleural fluid VEGF levels. The VEGP level was most closely correlated with the lactate dehydrogenase level (r = 0.42, p < 0.001) and was also significantly col related with die total pleural al fluid protein level. The median VECF levels in the pleural fluid of patients with breast cancer ere significantly lower (p = 0.017) than in those with lung cancer. The VEGF level was very high (3,201 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 al fluid accumulation in at least some situations.