use of more than one biochemical test to improve their predictive value for the diagnosis of malignant ascites

ABSTRACT

A battery of 4 tests, including serum carcino-embryonic antigen [CEA] ascitic fluid fibronectin, total protein and cholesterol, was studied to assess the diagnostic value of the tests individually and combined in ascetic patients. 40 subjects were included, 15 with non malignant ascitic, 15 with malignant ascitic and 10 healthy control subjects. Mean serum and CEA ascitic fluid fibronectin were significantly higher [P < 0.01] in patients with malignant ascitic when compared to those with non malignant ascitic. The predignant ascites were 70% for serum CEA, 76% for ascetic fluid febronectin and 81% for ascetic fluid cholesterol. A combination of more than one test was found to improve the predictive value. Thus it was 92% for ascetic fluid fibronectin and serum CEA_., 95% for ascetic fluid febronectin and cholesterol and 92% for serum CEA and ascetic fluid cholesterol. It thus seems prudent to make a combination of two tests to achieve a better diagnostic yield