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Comparison of Vascular Endothelial Growth Factor-A (VEGF-A) Level in Pleural Fluid of Patients with Malignant and Nonmalignant Pleural Effusion

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Abstract

Malignant pleural effusion (PE) is a complication that often occurs in advanced cancer. The sensitivity of pleural fluid cytology is reported to vary from 30 to 90%; therefore, the process is less clinically practical in certain conditions. Thus, special biomarkers are needed to distinguish malignant PE and nonmalignant PE. The aim of this study is to compare the level of vascular endothelial growth factor-A (VEGF-A) in pleural fluid of patients with that in malignant and nonmalignant PE. Participants were divided into 2 groups: 19 patients with nonmalignant PE, and 34 patients with malignant PE. Both groups underwent pleural puncture procedures and were examined for VEGF-A levels. Statistical analysis was performed using the paired test or Mann–Whitney test. The ROC curve was employed to determine the VEGF-A cut-off value in malignant PE. The VEGF-A level in pleural fluid of malignant PE group was 1940.77 ± 1016.54 pg/mL, while the nonmalignant group was 178.16 ± 192.01 pg/mL (p < 0.001; 95% CI). The average VEGF-A level in malignant PE group with positive anatomic pathology results was 2036.69 ± 1008.15 pg/mL, and negative was 1855.51 ± 1045.35 pg/mL (p = 0.612; 95% CI). The cutoff value for VEGF-A level in pleural fluid for the diagnosis of malignant PE was 416.60 pg/mL with a sensitivity and specificity of 85.29% and 84.22% respectively. Examination of VEGF-A level in pleural fluid can be considered as a means of supporting the diagnosis of malignant PE.

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Acknowledgments

We thank Ms. Rossellini Ngiono B. Sc for her dedicated time to review and proofread our manuscript.

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Authors and Affiliations

  1. Department of Pulmonology and Respiratory, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo no. 6-8, Airlangga, Gubeng, Surabaya, 60286, Indonesia

    Wahyuni Hariyanto & Isnu Pradjoko

  2. Thoracic Oncology Division, Department of Pulmonology and Respiratory, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, 60286, Indonesia

    Laksmi Wulandari

  3. Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, 60286, Indonesia

    Gatot Soegiarto

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  1. Wahyuni Hariyanto
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  2. Laksmi Wulandari
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  3. Isnu Pradjoko
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  4. Gatot Soegiarto
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All authors contributed toward data analysis, drafting and revising the paper, gave final approval of the version to be published and agree to be accountable for all aspects of the work.

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Correspondence to Laksmi Wulandari.

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Hariyanto, W., Wulandari, L., Pradjoko, I. et al. Comparison of Vascular Endothelial Growth Factor-A (VEGF-A) Level in Pleural Fluid of Patients with Malignant and Nonmalignant Pleural Effusion. Indian J Surg 83, 132–138 (2021). https://doi.org/10.1007/s12262-020-02204-z

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  • DOI: https://doi.org/10.1007/s12262-020-02204-z

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