title: Prognostic value of pro-inflammatory cytokine and pro-angiogenesis factor in differentiating malignant from benign exudative effusion.
abstract: OBJECTIVE
  The precise mechanism of pathogenesis in exudation of effusions is uncertain. Released factors in inflammation and malignancy of pleura are related to incremented permeability of the micro-pleural vessels. Angiopoietins (Ang) take part in development of angiogenesis and pleural inflammation. Interleukin-8 (IL-8) influences proliferation and tumor angiogenesis and it is expressed in cancer. The aims of this study were to investigate the relationship between inflammation, angiogenesis and etiologies of exudative effusions, and to evaluate the diagnostic value in differentiating malignant from benign.
  
  
  METHODS
  The study includes 49 pleural fluid (PF) samples. Ang-2 and IL-8 in PF and serum were estimated.
  
  
  RESULTS
  Ten patients were transudative and 39 patients were exudative fluid, subdivided into 16 benign and 23 malignant effusion. Ang-2 and IL-8 either fluid level or ratio were in significantly high in exudative more than in transudative fluid (P = 0.002). Ang-2 and IL-8 in PF were in high level than in serum of exudative and transudative. Ang-2 fluid level and ratio were significantly high in benign exudative effusion (P = 0.01, P = 0.05, respectively), while IL-8 level was significantly high in malignant exudative effusion (P = 0.04). Cut-off points for PF Ang-2 and IL-8 in differentiating malignant from benign exudative were 15.67 ng/mL, 325.54 pg/mL, respectively.
  
  
  CONCLUSIONS
  Our results support the evidence that angiogenesis and inflammatory pathways are linked, and that inflammation and vascular permeability of pleura constitutes the pathogenic basis of the majority of exudative effusion.
authors.affiliation: Department of Chest Diseases, Fayoum University, Cairo, Egypt.
authors.forename: Radwa Ahmed
authors.initials: RA
authors.lastname: Elhefny
authors.affiliation: Department of Chest Diseases, Cairo University, Cairo, Egypt.
authors.forename: Marwa Moawad
authors.initials: MM
authors.lastname: Shaban
authors.affiliation: Department of Chemical Biochemistry and Molecular Biology, Cairo University, Cairo, Egypt.
authors.forename: Olfat Gamil
authors.initials: OG
authors.lastname: Shaker
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D003937:Diagnosis, Differential; D005122:Exudates and Transudates / Q000378:metabolism*; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D011379:Prognosis; D033921:Vesicular Transport Proteins / Q000097:blood / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C508606:CXCL8 protein, human; D016209:Interleukin-8; C555023:VPS51 protein, human; D033921:Vesicular Transport Proteins
keywords: angiopoietin-2; diagnosis; exudative effusions; interleukin-8; malignant effusion