Diagnostic value of vascular endothelial growth factor and endostatin in malignant pleural effusions.

OBJECTIVE

To assess the value of vascular endothelial growth factor (VEGF) and endostatin in the differential diagnosis of malignant and tuberculous pleural effusions (PE).

METHODS

Effusion samples were collected from 62 patients with malignant PE caused by lung cancer and from 64 patients with tuberculous pleurisy. Concentrations of pleural fluid VEGF and endostatin were measured simultaneously using enzyme-linked immunosorbent assay (ELISA) and enzyme immunoassay, respectively. The sensitivity, specificity and accuracy were calculated.

RESULTS

PE levels of VEGF and endostatin were found to be significantly elevated in effusions with malignancy rather than in those of tuberculous origin (both P < 0.01). For VEGF, the sensitivity, specificity and accuracy in diagnosing malignant pleural effusions were respectively 71%, 61% and 66%, while for endostatin the values were respectively 69%, 83% and 76%. A combination of VEGF and endostatin can increase these to respectively 81%, 97% and 89%.

CONCLUSIONS

Elevated levels of VEGF and endostatin in pleural effusions may be helpful in diagnosing malignant pleural effusions, while a combination of VEGF and endostatin can increase the sensitivity, specificity and accuracy of differentiating malignant from tuberculous pleural effusions.