Preliminary investigation of the clinical value of vascular endothelial growth factor and hypoxia-inducible factor-1alpha in pericardial fluid in diagnosing malignant and tuberculous pericardial effusion.
OBJECTIVE
To investigate the clinical value of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1alpha (HIF-1alpha) in diagnosing malignant and tuberculous pericardial effusion.


METHODS
Eighty patients with exudative pericardial effusion undergoing pericardiocentesis and drainage were divided into 2 groups, namely those with malignancy and those with tuberculosis. The levels of HIF-1alpha, VEGF, lactate dehydrogenase (LDH) and adenosine deaminase (ADA) in pericardial fluid and serum were measured. Routine and cytological examination of pericardial fluid, clinical characteristics and some blood parameters were compared between the 2 groups.


RESULTS
There were 33 patients with tuberculous pericardial effusion and 47 with malignant pericardial effusion. The levels of VEGF and HIF-1alpha in pericardial fluid in the malignancy group were significantly higher than those in the tuberculosis group (p < 0.01), and there was a moderate positive correlation between the levels of VEGF and HIF-1alpha (r = 0.79, p < 0.01). The sensitivity and specificity of combining VEGF and HIF-1alpha were 90.8 and 88.3%, respectively. The 2 groups showed no differences with regard to gender distribution, occurrence of fever, erythrocyte sedimentation rate or the levels of hemoglobin, LDH, ADA, serum HIF-1alpha and VEGF.


CONCLUSIONS
Both VEGF and HIF-1alpha in pericardial fluid have determinative value in the differential diagnosis of malignant and tuberculous pericardial effusion.
Liu
Jiani
J
Department of Internal Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, China.
Zeng
Yan
Y
Ma
Wenfei
W
Chen
Shaohua
S
Zheng
Yali
Y
Ye
Shan
S
Lan
Ling
L
Weig
Hans-Joerg
HJ
Liu
Qigong
Q
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism*; D001826:Body Fluids / Q000378:metabolism; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000209:etiology / Q000378:metabolism / Q000382:microbiology; D020519:Pericardiocentesis; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D014381:Tuberculosis, Cardiovascular / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D015415:Biomarkers; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A