Malign plevral efüzyonların farklılaşmasında anjiyopoietin-2'nin tanısal değeri

Amaç: Anjiopoietinler, malign plevral efüzyon (MPE) patogenezinde ana basamaklar olan inflamasyon, anjiyogenez ve vaskuler permeabilite artışının düzenlenmesinde önemli bir rol oynamaktadır. Çalışmamızda, malign plevral efüzyonların diğer efüzyonlardan ayrımında plevra sıvı anjiopoietin 2 (Ang-2) seviyelerinin tanısal değerini araştırdık.Yöntemler: Bu çalışma, tek merkezli vaka kontrol çalışması olarak tasarlandı. Çalışmamıza, 13 transüda, 28 benign eksüda ve 25 malign plevral sıvıya sahip (malign eksüda) toplam 66 hasta alındı. Çalışmaya hasta grubu olarak olarak MPE tanısı konulmuş 25 hasta alındı. MPE tanılı hastalar; akciğer veya diğer organ maligniteleri mevcut olan ve plevral sıvının maligniteye bağlı olarak olarak geliştiği hastalardan oluştu. Kontrol grubu olarak, Light kriterlerine göre transüda olduğu saptanan 13 hasta ve MPE dışındaki eksüda vasıflı (parapnomonik, tüberküloz plörezi, emboli vb) 28 hasta olmak üzere toplam 41 hasta dahil edildi.Bulgular: Plevral sıvı Ang-2 seviyeleri, hem benign eksüda hem de malign eksüda vasfındaki sıvılarda transüda vasfındaki plevral sıvılara göre belirgin olarak yüksek bulundu (P=0,001). Benign eksüda grubunda plevra Ang-2 seviyeleri malign eksüda grubuna göre yüksek olarak saptandı ancak bu durum istatistiksel olarak anlamlı değildi (P=0,874). Eksüda vasıflı plevral sıvılarda Ang-2 düzeyi 13,84 değerinin üzerinde saptanmış olan bir hastada malign plevral efüzyon olma riski, 13,84 değerinin altında olan bir hastaya göre 1,87 kat fazla bulundu.Sonuç: Ang-2’nin, transüda ve eksüda özelliğindeki plevral sıvıların ayrımında kullanılabilir olmasına rağmen, eksüdatif plevral sıvılarda, malign ya da benign ayrımı yapmada yetersiz olduğu saptandı.

Anahtar Kelimeler:

Anjiopoietin 2, Malign plevral efüzyon, Eksüdatif plevral efüzyon

Diagnostic value of angiopoietin-2 in the differentiation of malignant pleural effusions

Aim: Angiopoietins play an important role in the regulation of inflammation, angiogenesis and increased vascular permeability, which are the main steps in the pathogenesis of malignant pleural effusions (MPEs). The present study investigates the diagnostic value of pleural fluid angiopoietin-2 (Ang-2) levels in the differentiation of malignant pleural effusions from other effusions.Methods: This research was designed as case-control study in a single-center. The study included a total of 66 patients (13 had transudate, 28 had benign exudate and 25 had malignant pleural effusions). The patient group involved 25 patients diagnosed with MPE, based on the criteria of lung cancer and other organ malignancies, and malignant pleural effusion. The control group consisted of 41 patients, 13 with transudate according to the Light criteria and 28 with exudate other than MPE (parapneumonic, tuberculous pleurisy, embolism, etc.). Results: Pleural fluid Ang-2 levels were found to be higher in both the benign and malignant exudates than in the transudative pleural effusions (P=0.001). Pleural fluid Ang-2 levels were higher in the benign exudate group than in the malignant exudate group, although the difference was not statistically significant (P=0.874). A patient with an exudative pleural effusion and a pleural fluid Ang-2 level of higher than 13.84 was found to be 1.87 times more likely to have a malignant pleural effusion.Conclusion: Despite the use of Ang-2 levels in the differentiation of transudative and exudative pleural effusions, the present study found that Ang-2 level cannot be used to differentiate between malignant and benign exudative pleural fluids.

Keywords:

Angiopoietin-2, Malignant pleural effusion, Exudative pleural effusion,

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