Study of some biochemical assays in serum and ascitic fluid for differentiation between cirrhotic and malignant ascites

The clinical diagnosis of ascites is an easy task but the etiological diagnosis of the type of ascites is occasionally a different problem. Many studies have investigated the possibility of using a single marker to detect cancer in ascitic patients; but no analysis of ascitic fluid including cytology has been shown to be specific and sufficiently sensitive for either hepatic or extrahepatic cancer. To evaluate the role of various biochemical parameters including cholesterol, LDH, total protein, albumin and glucose for the differentiation of cirrhotic ascites from malignancy related ascites, fifty ascitic patients were classified into three main groups: Group I: included 20 patients with cirrhotic ascites. Group II: included 15 ascitic patients with hepatocellular carcinoma on top of liver cirrhosis. Group III: included 15 ascitic patients with extrahepatic malignancy without liver cirrhosis. All patients were subjected to: clinical history and examination, various imaging, routine laboratory investigations, histopathological examination, cytological examination of ascitic fluid, and biochemical analysis of both serum and ascitic fluid. We found that, although cytological examination of ascitic fluid is specific, it is less sensitive than ascitic fluid biochemical analysis in determining the cause of ascites. The accuracy of ascitic fluid cholesterol LDH, SAAG, A/S LDH ratio, A/S cholesterol ratio, A/S protein ratio, AFTp and ascitic/blood glucose ratio in discrimination of exudative malignant ascites from transudative cirrhotic ascites are [91%, 91%, 91%, 86%, 83%, 83%, 80% and 71%] respectively. Ascitic fluid biochemical analysis may be useful than cytological examination in follow-up of cirrhotic ascitic patients aiming to early detection of complication

prevalence of anti-hepatitis B core antigen in patients with chronic hepatitis C virus related complications [liver cirrhosis and hepatocellular carcinoma]

This study included 200 patients with chronic HCV related complications [as liver cirrhosis and HCC]. Ch. HCV proved by PCR, liver biopsy and histopathological examination. Hundred healthy individuals of comparable age and sex constituted the control group. This study showed 24.5% with chronic HCV related complications were positive for anti-HBc, antibody. The percentage of patients testing positive for anti-HBc antibody was statistically significantly higher in cases of HCC than in cases of liver cirrhosis. The anti-HBc antibody was the only serological marker for HBV infection in a significant number of patients with chronic HCV related complications when HBV DNA negative by PCR. On the other hand, there was no relation between a past history of blood transfusion and the prevalence of anti-HBc antibody in patients with Ch. HCV related complications

Estimation of urinary transforming growth factor beta - 1 levelsin patients with chronic active hepatitis c virus and liver cirrhosis

This study included 21 patients with chronic active hepatitis C virus [CAM. CV] Group I and 18 patients with liver cirrhosis group II, both proved by liver biopsy. Only patient with normal serum creatinine were included in this study, and urinary creatinine was used to normalize the urinary TGF - B1 level.Twenty healthy individuals of comparable age and sex constituted the control group.This study showed that the urinary TGF-BI level was significantly higher in group 1[5.52 +/- 6.63ng/mg creatinine] than in the control group [0.185 +/- 0.15 ng.mg creatinine] ,with P value < 0.001 . As regards the Histological Activity Index [HAI], there was a significant difference between urinary level of TGF-Bi in patients with mild disease [2.8 +/- 2.4 ng/rng creatinine] and those with moderate to marked disease [11.3 +/- 8.5 ng/mg creatinine] with P value <0.05 . Urinary level of TGF-BI was also significantly higher in group II [3.45 +/- 4.18 ng/mg creatinine] than in the control group [0.185 +/- 0.15 ng/mg creatinine] with P value < 0.001. It was also higher in cirrhoticpatients with Child - B to C [9.3 +/- 4.8 ng/mg creatinine] than in those with Child - A [1.81 +/- 1.86 ng/ing creatinine] with P value < 0.05 .In conclusion, urinary TGF - B1 level may be used as a marker for hepatic fibrogenesis , and a higher urinary TGF - Bl levels correlate with more severe liver disease