Tohoku J. Exp. Med., 2017 June, 242(2)

Diagnostic Significance of Measuring Vascular Endothelial Growth Factor for the Differentiation between Malignant and Tuberculous Pleural Effusion

HAK-RYUL KIM,¹ BYOUNG-RYUN KIM,² RAE-KIL PARK,³ KWON-HA YOON,⁴ EUN-TAIK JEONG¹ and KI-EUN HWANG¹

¹Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University, School of Medicine, Iksan, Jeonbuk, Korea
²Department of Obstetrics and Gynecology, Institute of Wonkwang Medical Science, Wonkwang University, School of Medicine, Iksan, Jeonbuk, Korea
³Department of Microbiology, Wonkwang University, School of Medicine, Iksan, Jeonbuk, Korea
⁴Department of Radiology, Wonkwang University, School of Medicine, Iksan, Jeonbuk, Korea

Malignancy and tuberculosis are common causes of lymphocytic exudative pleural effusion. However, it is occasionally difficult to differentiate malignant pleural effusion from tuberculous pleural effusion. Vascular endothelial growth factor (VEGF) is a critical cytokine in the pathogenesis of malignant pleural effusion. Endocan is a dermatan sulfate proteoglycan that is secreted by endothelial cells. Importantly, endocan mediates the vascular growth-promoting action of VEGF. The aim of this study was to evaluate the diagnostic significance of VEGF and endocan in pleural effusion. We thus measured the levels of VEGF and endocan in the pleural effusion and serum samples of patients with lung cancer (n = 59) and those with tuberculosis (n = 32) by enzyme-linked immunosorbent assay. Lung cancer included 40 cases of adenocarcinoma, 13 of squamous cell carcinoma, and 6 of small cell carcinoma. Pleural effusion VEGF levels were significantly higher in the malignant group than in the tuberculosis group (2,091.47 ± 1,624.80 pg/mL vs. 1,291.05 ± 1,100.53 pg/mL, P < 0.05), whereas pleural effusion endocan levels were similar between the two groups (1.22 ± 0.74 ng/mL vs. 0.87 ± 0.53 ng/mL). The areas under the curve of VEGF and endocan were 0.73 and 0.52, respectively. Notably, the VEGF levels were similar in malignant pleural effusion, irrespective of the histological type of lung cancer. Moreover, no significant difference was found in the serum VEGF and endocan levels between patients with lung cancer and those with tuberculosis. In conclusion, high VEGF levels in pleural effusion are suggestive of malignant pleural effusion.

keywords —— endocan; malignancy; pleural effusion; tuberculosis; vascular endothelial growth factor

© 2017 Tohoku University Medical Press

===============================

Tohoku J. Exp. Med., 2017, 242, 137-142

Correspondence: Ki-Eun Hwang, M.D., Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University, School of Medicine, 895 Muwang-ro, Iksan, Jeonbuk 54538, Korea.

e-mail: eyesmile@wku.ac.kr