title: Pleural fluid osteopontin, vascular endothelial growth factor, and urokinase-type plasminogen activator levels as predictors of pleurodesis outcome and prognosticators in patients with malignant pleural effusion: a prospective cohort study.
abstract: Rapidly growing cancer cells secrete growth-promoting polypeptides and have increased proteolytic activity, contributing to tumor progression and metastasis. Their presentation in malignant pleural effusion (MPE) and their predictive value for the outcome of pleurodesis and survival were studied.
  
  
  
  Between February 2011 and March 2012, MPE samples were prospectively collected from 61 patients. Twenty-five patients with non-malignant pleural effusion in the same period were included as controls. Pleural fluid osteopontin (OPN), vascular endothelial growth factor (VEGF), and urokinase-type plasminogen activator (uPA) concentrations were measured.
  
  
  
  Patients with MPE had higher pleural fluid OPN, VEGF, and uPA concentrations than those with non-malignant pleural effusion, but only differences in VEGF were statistically significant (p = 0.045). Patients with distant metastases had significantly elevated pleural fluid VEGF concentrations than those without (p = 0.004). Pleural fluid OPN, VEGF, and uPA concentrations were positively correlated in most patients. However, there was no significant difference in pleural fluid OPN, VEGF, and uPA concentrations between patients with successful pleurodesis and those without. There was also no significant difference in cancer-specific survival between sub-groups with higher and lower pleural fluid OPN, VEGF, or uPA concentrations. Patients with successful pleurodesis had significantly longer cancer-specific survival than those without (p = 0.015).
  
  
  
  Pleural fluid OPN, VEGF, and uPA concentrations are elevated in MPE but are not satisfactory predictors of pleurodesis outcome or survival. Patients with higher pleural fluid VEGF concentration have higher risk of distant metastasis. Evaluating the benefits of therapy targeting the VEGF pathway in these patients warrants further studies.
authors.affiliation: Ph.D. for Medical Biotechnology Program, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.|Department of Medicine, National Yang-Ming University Medical School, Taipei, Taiwan.|Division of Pulmonary and Critical Care Medicine, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Li-Han
authors.initials: LH
authors.lastname: Hsu
authors.affiliation: School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110, Taiwan.
authors.forename: Pei-Chi
authors.initials: PC
authors.lastname: Hsu
authors.affiliation: School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110, Taiwan.
authors.forename: Tien-Ling
authors.initials: TL
authors.lastname: Liao
authors.affiliation: Department of Research, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: An-Chen
authors.initials: AC
authors.lastname: Feng
authors.affiliation: Department of Medical Oncology, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Nei-Min
authors.initials: NM
authors.lastname: Chu
authors.affiliation: Ph.D. for Medical Biotechnology Program, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan. kaosh@tmu.edu.tw.|School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110, Taiwan. kaosh@tmu.edu.tw.
authors.forename: Shu-Huei
authors.initials: SH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D005122:Exudates and Transudates / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053495:Osteopontin / Q000032:analysis*; D016066:Pleural Effusion, Malignant / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018700:Pleurodesis; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D014568:Urokinase-Type Plasminogen Activator / Q000032:analysis*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
chemical_list: C506895:SPP1 protein, human; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D053495:Osteopontin; D014568:Urokinase-Type Plasminogen Activator
keywords: Malignant pleural effusion; Osteopontin; Pleurodesis; Survival; Urokinase-type plasminogen activator; Vascular endothelial growth factor