| Abstrakt: |
Background: It is crucial to differentiate between benign and malignant pleural effusions while making a diagnosis. The purpose of this research was to investigate the diagnostic significance of GSDMD and VEGF in discriminating between different kinds of pleural effusion and their correlation with both progression-free and overall survivals in the malignant type. Methods: Ninety-one pleural fluid samples, which were classified as transudates or exudates (tuberculous, para-infectious, or malignant) by pleural fluid classifications, were tested for GSDMD using sandwich ELIZA kits, and 41 of the exudative samples were randomly selected for VEGF testing. Both markers' diagnostic accuracy was assessed. Results: The lowest level of GSDMD was associated with the transudate group (mean and SD of 2.35 ± 0.44 ng/mL) and the highest in the malignant effusion group (mean and SD of 4.38 ± 1.67 ng/mL). The specificity and sensitivity of GSDMD in the diagnosis of exudative PE were 97% and 98%, respectively (p= 0.001) with the cutoff point = 2.89). Regarding VEGF, its level was 222.3 ± 53.4 pg/ml for all studied samples where MPE (n= 21) was 261.2 ± 48.2 pg/ ml (mean ± SD), TBPE (n= 7) was 185.4 ± 6.96 pg/ml (mean ± SD), and PIPE (n= 13) was 179.3 ± 13.9 pg/ml (mean ± SD). The diagnostic accuracy of VEGF for the detection of MPE was 90% with a sensitivity of 100% and specificity of 80% and the cutoff point was 191.5 pg/ml. There were highly significant inverse correlations between progression-free survival and both GSDMD (r=− 0.531, p= 0.009) and VEGF (r= − 0.582, p= 0.006) in MPE. Conclusion: Pleural effusion GSDMD can be an effective marker for differentiating the different kinds of PE, and VEGF levels can be a useful adjuvant marker in screening out MPE as a possible diagnosis, leading to the proper selection of patients who may benefit from more invasive procedures. |
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