الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Pleural effusion is accumulation of fluids in the pleural cavity; it may be
exudative effusion or transudative effusion according to protein
concentration and lactic dehydrogenase enzyme concentration in the
pleural fluid.
Malignancy, TB and pneumonia are the leading causes of exudative
effusion, While Congestive heart failure and hypoproteinemia are the
leading causes of transudative effusion.
Diagnosis of malignant pleural effusion is difficult as the pleural fluid
. .
cytology is positive only in about 50% of cases while needle biopsy of
. .
the pleura provides diagnosis in 40~75% of cases. The use of fibreoptic
bronchoscopy and thoracoscopy can reveal the diagnosis but all of these
techniques are invasive and expensive and can not be done routinely.
Moreover the use of tumours markers such as carcino- embryonic antigen
is not sensitive in the diagnosis.
So the search of other sensitive non- invasive technique is very useful in
the diagnosis.
Vascular endothelial growth factor is a cytokine associated with
. .
angiogenisis and was reported to be increased in malignancy.
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Therefore the purpose of this study was to evaluate the vascular
endothelial growth factor in the diagnosis of’malignant pleural effusion.
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The present study was conducted on thirty patients with exudative pleural
effusion that were admitted to Damanhour oncology center, Damanhour
chest hospital and Maamoura chest hospital.
These patients were subjected to the following:
* History taking
* Physical examination
* Chest x-ray postero-anterior and lateral view
* Complete blood picture, sedimentation rate, :asting and post prandial
blood glucose.
* Examination of pleural fluid:
Physical examination
Cytological examination
Bacteriological examination
Chemical examination-including estimation of vascular endothelial
growth factor.
Pleural biopsy, CT scan and fibreoptic bronchoscopy in some
patients. .~
Estimation of vascular endothelial growth factor in every patient
serum.
These patients in the present study were classified into three groups
I-Ten patients with malignant pleural effusion.
2-Ten patients with tuberculous pleural effusion.
2·Ten patients with pneumonic pleural effusion .
The present study showed the following results:
-The level of vascular endothelial growth fa~.tor~as significantly higher
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in the pleural fluid of the malignant group comparing with the
tuberculous and the pneumonic groups.
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