Background: Apolipoprotein E (apoE) levels have been shown to be elevated in pleural effusion of patients with non-small cell lung cancer (NSCLC). However, the diagnostic value of apoE in pleural effusion in NSCLC has not been well validated and established.
Methods: Samples of malignant pleural effusions (MPE) and benign effusions were collected and analyzed for apoE, tumor markers, and other biochemical changes.
Results: ApoE levels were significantly higher in MPE (n=160) than in benign pleural effusions (n=40). They were higher in adenocarcinoma-associated MPE than in squamous cell carcinoma- and large cell carcinoma-associated MPE. The receiver operating characteristic curve showed that the sensitivity and specificity of apoE for the diagnosis of MPE were 87.5% and 85.3%, respectively, at the cutoff 105 ng/ml, and the area under the curve (AUC) was 0.748. For the diagnosis of adenocarcinoma-associated MPE, apoE achieved sensitivity and specificity of 70.8% and 83.30%, respectively, and the AUC was the highest of all the markers.
Conclusions: ApoE levels are significantly increased in the pleural effusion of patients with NSCLC. Increased concentration of apoE in a pleural effusion is a potential marker for the diagnosis of MPE as well as for differential diagnosis of MPE in NSCLC.
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