title: A potential role for VEGF in the diagnostic approach of pleural effusions.
abstract: BACKGROUND
  Vascular endothelial growth factor (VEGF) may play a role in pleural fluid formation, as it represents a potent inducer of capillary permeability. We aimed to investigate the diagnostic utility of VEGF levels in pleural fluid and serum in patients with pleural effusions with initially negative diagnostic work up.
  
  
  METHODS
  Seventy-one patients with exudative lymphocytic pleural effusions undiagnosed after initial diagnostic work up were enrolled in this prospective study and their clinical course was followed up to 24 months. VEGF levels were measured in serum and pleural fluid by using immunoenzymometric assay.
  
  
  RESULTS
  During the follow up period, in 43 patients the pleural effusion was eventually attributed to malignancy while in the rest 28 patients it was due to non-malignant causes (benign and unknown origin). Patients with malignancy had significantly higher VEGF levels in pleural fluid compared to patients with non-malignant effusions (1,506 vs. 588 pg/dL, P=0.0001), while no statistically significant difference was found in the VEGF serum levels between the two groups.
  
  
  CONCLUSIONS
  Pleural VEGF levels may be helpful in identifying malignant pleural effusion (MPE) in patients with negative diagnostic work up at the initial assessment and help in selecting patients for more invasive procedures.
authors: Department of Respiratory Medicine, University of Thessaly, Medical School, Larissa, Greece.
authors: Aggeliki
authors: A
authors: Psatha
authors: Department of Critical Care Medicine, University of Thessaly, Medical School, Larissa, Greece.
authors: Demosthenes
authors: D
authors: Makris
authors: Department of Respiratory Medicine, University of Thessaly, Medical School, Larissa, Greece.
authors: Theodora
authors: T
authors: Kerenidi
authors: Department of Respiratory Medicine, University of Thessaly, Medical School, Larissa, Greece.
authors: Zoe
authors: Z
authors: Daniil
authors: Department of Respiratory Medicine, University of Thessaly, Medical School, Larissa, Greece.
authors: Theodoros
authors: T
authors: Kiropoulos
authors: Department of Respiratory Medicine, University of Thessaly, Medical School, Larissa, Greece.
authors: Konstantinos
authors: K
authors: Gourgoulianis
keywords: Vascular endothelial growth factor (VEGF); diagnostic biomarker; lymphocytic pleural effusion; malignant pleural effusions (MPEs)