Abstract
The precise pathogenetic mechanisms of exudative effusions are still unsettled. Incremented permeability of the pleural microvasculature is attributed to factors that are released in inflammatory and malignant pleural diseases. Angiopoietin 2 (Ang-2) plays an essential role in angiogenesis and takes part in pleural inflammation. Interleukin-8(IL-8) influences proliferation and tumor angiogenesis. Objective: to investigate the relationship between inflammation, angiogenesis and etiologies of exudative effusions and its diagnostic value in differentiating malignant from benign effusion. Methods: the study includes 49 pleural fluid (PF) samples. PF and serum Ang-2, IL-8 levels were estimated. Results: ten patients had transudative and 39 patients had exudative effusions, subdivided into 16 benign and 23 malignant effusion. Both PF Ang-2 and IL-8 levels; and pleural fluid / serum ratio of Ang-2 and IL-8 were significantly higher in exudates than in transudates. PF Ang-2 and IL-8 levels were higher than serum Ang-2 level in both exudates and transudates. Both PF Ang-2 level and pleural fluid/serum ratio were significantly higher in benign than in malignant exudates while PF IL8-level was significantly higher in malignant than in benign exudates. Cut-off points for PF Ang-2 and PF IL8 in differentiating malignant from benign exudates were 15.67 ng/ml and 325.54 pg/ml respectively. Conclusion: our results support the evidence that both angiogenesis and inflammatory pathways are closely linked and that pleural inflammation and vascular permeability constitute the patho-genetic basis of the vast majority of exudative effusion.
- © 2014 ERS