Study On The VEGF And ICAM-1 Activity In The Pleural Effusion

Aims: The aim of the study was to determine the activity of vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1) in various type of pleural effusions so as to provide scientific basis for clinical diagnosis and treatment of pleural effusion.Methods: A total of 58 cases of pleural effusion were collected individually by respiratory department from July 2005 to December 2005. Half of them were from patients with known carcinoma diagnosed by cytomorphology and the other half from those without known carcinoma. The gene expression levels of VEGF and ICAM-1 were determined using polymerase chain reation(PCR). The products of PCR were semi-quantitatively analyzed by agrose electrophresis and image analysis system. Data was statistically analyzed by SAS software. The comparativeexpression level was analyzed by T-test and the cDNA content of each speciment were demonstrated as x± s. Correlation analysis was analyzed by linear correlation analysis. P<0.05 was considered to be of significance. The relationship between the expression level of VEGF and ICAM-1 and the related clinicopathological factors of pleural effusion was investigated.Results:VEGF level in the group of malignant pleural effusion and benign pleural ones were 0.447± 0.112 and 0.302±0.119 respectively. ICAM-1 level in the group of malignant pleural effusion and benign pleural ones were 0.481± 0.103 and 0.337±0.152 respectively. The expression levels of both VEGF and ICAM-1 in malignant pleural effusions were significantly higher than those in benign ones(P < 0.01). ICAM-1 level was positively correlated with sCEA and pCEA level (Pearson correlation analysis, r = 0.400, P = 0.03 and r = 0.502, P =0.006, respectively). In the group of malignant pleural effusion, significant differences of VEGF level was found in different level of cell differentiation. While, there were no significant correlation between the VEGF level and the pathological type or the clinical stage of the primary tumor. Significant differences of ICAM-1 level was found in different level of cell differentiation and different clinical stage of the primary tumor. ICAM-1 level in the malignancy group and tuberculosis group were 0.481±0.103 and0.337±0.152 respectively, and VEGF level in the malignancy group and tuberculosis group were 0.447±0.112 and 0.305±0.120 respectively, demonstrating a significance between the malignancy group and the buberculosis group in both VEGF and ICAM-1.Conclusion:1. Both VEGF and ICAM-1 levels in the malignant pleural effusion were significantly higher than the group without malignancy indicating that detections of VEGF and ICAM-1 levels in the pleural effusion may be useful in the differentiate diagnosis of malignant pleural effusion, especially in those malignancy with negative cytomorphology results.2. Both VEGF level and ICAM-1 level were higher in the malignant pleural effusion than in the tuberculosis group.3. ICAM-1 level was positively correlated with sCEA and pCEA level respectively indicating the greater value of combination of them in the qualitative diagnosis of pleural effusion.4. VEGF level was negatively correlated with the level of tumor cell differentiation indicated that the overexpression of VEGF may provide a diagnosis marker for the malignant pleural effusion.