Abstract | OBJECTIVES: METHODS: RESULTS: Serum VEGF-D levels were significantly greater in S- LAM (median 1,175 [interquartile range (IQR): 780-2,013] pg/mL; n = 56) than in other cystic lung diseases (median 281 [IQR 203-351] pg/mL; n = 44, P < .001). In the cohort evaluated prospectively, 12 of the 15 individuals ultimately diagnosed with LAM by biopsy had VEGF-D levels of > 800 pg/mL, whereas levels were < 600 pg/mL in all 18 subjects later diagnosed with other causes of cystic lung disease. Receiver operating characteristic curves demonstrated that VEGF-D effectively identified LAM, with an area under the curve of 0.961(95% CI, 0.923-0.992). A VEGF-D level of > 600 pg/mL was highly associated with a diagnosis of LAM (specificity 97.6%, likelihood ratio 35.2) and values > 800 pg/mL were diagnostically specific. Serum VEGF-D levels were significantly elevated in women with TSC- LAM (median 3,465 [IQR 1,970-7,195] pg/mL) compared with women with TSC only (median 370 [IQR 291-520] pg/mL), P < .001). CONCLUSIONS: A serum VEGF-D level of > 800 pg/mL in a woman with typical cystic changes on high-resolution CT (HRCT) scan is diagnostically specific for S- LAM and identifies LAM in women with TSC. A negative VEGF-D result does not exclude the diagnosis of LAM. The usefulness of serum VEGF-D testing in men or in women who do not have cystic lung disease on HRCT scan is unknown.
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Authors | Lisa R Young, Rhonda Vandyke, Peter M Gulleman, Yoshikazu Inoue, Kevin K Brown, Laura S Schmidt, W Marston Linehan, Fuad Hajjar, Brent W Kinder, Bruce C Trapnell, John J Bissler, David N Franz, Francis X McCormack |
Journal | Chest
(Chest)
Vol. 138
Issue 3
Pg. 674-81
(Sep 2010)
ISSN: 1931-3543 [Electronic] United States |
PMID | 20382711
(Publication Type: Controlled Clinical Trial, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers, Tumor
- Vascular Endothelial Growth Factor D
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Topics |
- Adolescent
- Adult
- Biomarkers, Tumor
(blood)
- Diagnosis, Differential
- Female
- Humans
- Lung Diseases
(blood, pathology)
- Lymphangioleiomyomatosis
(blood, diagnosis)
- Middle Aged
- Predictive Value of Tests
- Prospective Studies
- ROC Curve
- Reproducibility of Results
- Vascular Endothelial Growth Factor D
(blood)
- Young Adult
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