Abstract: Objective To explore the diagnostic value of combined detection of vascular endothelial growth factor (VEGF), interleukin-33 (IL-33), adenosine deaminase 2 (ADA2), and angiotensin converting enzyme (ACE) in the properties of pleural effusion. Methods Using a retrospective analysis, 100 cases of patients with pleural effusion who underwent thoracic puncture and drainage at Dali County Hospital from January 2018 to January 2021 were selected. Among them, there were 58 cases of patients were diagnosed as malignant (malignant group) and 42 cases of patients were diagnosed as benign (benign group). In addition, the other 20 cases of non pleural effusion patients diagnosed according to the Light diagnostic criteria at Dali County Hospital during the same period were selected as the control group. All patients were tested for pleural effusion, with detection indicators of VEGF, IL-33, ADA2, and ACE, Analyze its expression situation; And analyze the effectiveness of detecting these four indicators separately and jointly in diagnosing malignant pleural effusion. Result There were significant differences in the expression levels of VEGF, IL-33, ADA2, and ACE in pleural effusion the three groups of patients (P<0.05). Among them, VEGF, ADA2, IL-33, and ACE were detected to have higher expression in the malignant group. The combination of four indicators for diagnosing the nature of pleural effusion has a higher effect than the individual diagnosis of each indicator, with increased sensitivity, specificity, and accuracy（P<0.05）. ROC curve analysis showed that the combined detection of VEGF, IL-33, ADA2, ACE and four indicators in pleural effusion had a diagnostic area under the curve of 0.810, 0.780, 0.760, 0.750, and 0.855 for malignant pleural effusion. Conclusion There is a significant difference in the levels of VEGF, IL-33, ADA2, and ACE in benign and malignant pleural effusions. The combined detection of VEGF, IL-33, ADA2, and ACE has a significantly higher diagnostic value for the nature of pleural effusions than a single indicator.

Key words: vascular endothelial growth factor, interleukin-33, adenosine deaminase 2, angiotensin converting enzyme, pleural effusion, diagnostic value