title: 25-hydroxyvitamin D in malignant pleural disease: a prospective cohort study.
abstract: BACKGROUND
  Growing evidence suggests a role of vitamin D in various cancers but the significance of vitamin D in malignant pleural disease remains unexplored. We sought to investigate the concentration and diagnostic role of 25-hydroxyvitamin D (25(OH)D) in malignant pleural effusions.
  
  
  METHODS
  Prospective study of consecutive treatment-naïve patients with a new diagnosis of pleural effusion.
  
  
  RESULTS
  Seventy-eight patients were studied, 45 of whom had malignant pleural effusions. Concentration of 25(OH)D in pleural fluid was significantly higher than serum in both malignant (15.2 ng/mL (9.7, 25.6) versus 10.2 ng/mL (6.4, 17.7), P < .001) and benign (11.4 ng/mL (8.4, 23.6) versus 7.9 (5.9, 16.1), P < .001) pleural disease. Pleural fluid 25(OH)D was almost significantly higher in exudates compared to transudates (P = .050) but it did not differ significantly between malignant and benign effusions (P = .217) and it was not diagnostic for malignant pleural disease (area under the ROC curve .58, 95% CI .45-.71).
  
  
  CONCLUSIONS
  In subjects with unselected pleural effusions, 25(OH)D in pleural fluid was not diagnostic for malignant pleural disease. The novel finding of convincingly and consistently higher 25(OH)D in pleural fluid than serum suggests a role for vitamin D in pleural disease and merits further research.
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Marios
authors: M
authors: Panagiotou
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Andriana I
authors: AI
authors: Papaioannou
authors: 2nd Respiratory Medicine Department, Attikon Hospital, University of Athens Medical School, Athens, Greece.
authors: Konstantinos
authors: K
authors: Kostikas
authors: Department of Biochemistry, Laiko General Hospital, Athens, Greece.
authors: Anna
authors: A
authors: Takou
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Maria
authors: M
authors: Paraskeva
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Alexandros
authors: A
authors: Kalkanis
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Filia
authors: F
authors: Diamantea
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Emmanuil
authors: E
authors: Kastanakis
authors: Department of Biochemistry, Laiko General Hospital, Athens, Greece.
authors: George
authors: G
authors: Maropoulos
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Vasiliki
authors: V
authors: Filaditaki
authors: 2nd Respiratory Medicine Department, Sismanoglio General Hospital, Athens, Greece.
authors: Napoleon
authors: N
authors: Karagianidis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood / Q000737:chemistry; D005122:Exudates and Transudates / Q000737:chemistry / Q000378:metabolism; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D010995:Pleural Diseases / Q000097:blood / Q000473:pathology* / Q000601:surgery; D016066:Pleural Effusion, Malignant / Q000097:blood / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D000069258:Thoracentesis / Q000379:methods; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: diagnosis; inflammation; malignant pleural effusion; vitamin D