Diagnostic value of blood and ascitic fluid concentrations of fibronectin, cholesterol and apolipoproteins in differentiation between malignant and non-malignant ascites

ABSTRACT

Sixty patients [28 males and 32 females] with ascites of unknown cause were examined. Their age ranged from 15 to 70 years, with a mean age of 42 years. The patients were classified into malignant ascites group [25 patients] and sterile uncomplicated ascites group [35 patients]. Patients with both malignant disease and liver cirrhosis were excluded. Serum and ascitic fluid discriminating value for tested parameters were calculated as follows Serum apo-A 1.9 g/L, plasma fibronectin 13 mg/dL, ascitic proteins 51.6 g/L, ascitic albumin 33.9 g/L, ascitic apo-A 0.8 g/L, ascitic apo-A-I 0.8 g/L, ascitic cholesterol was 97.9 mg/dL, ascitic triglyceride 66.5 mg/dL, ascitic HDL 0.45 g/L, ascitic LDL 65.5 mg/dL, A/S protein ratio 0.7 and A/S apo A-I ratio 0.9. Ascitic proteins and serum-ascitic albumin concentration gradient failed to show remarkable discriminating value between both types of ascites. Meanwhile, ascitic-serum protein ratio showed better sensitivity [65%] than ascitic total proteins [45%] and serum-ascitic albumin gradient [35%]. Ascitic proteins despite their rather low specificity, had good positive predictive value [75%]