Clinical Significance Of Detecting Multi-indicators In Ascites

OBJECTIVETo study the levels and clinical significance of cytokines, c-reactive protein (CRP), carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH) in ascites from patients with liver cirrhosis with spontaneous bacterial peritonitis (SBP), malignant tumors and kidney disease.METHODSBlood and ascites were collected in patients with26cases of SBP,31cases of malignant tumors,12cases of kidney disease.Blood routine, biochemistry; ascites routine and bacterial culture were routinely done to all of the patients, enzyme-linked immunosorbent assay (ELISA) test in which IL-6, TNF-a, VEGF biological activity, Abbott Ci8200automatic analyzer CRP, CEA, LDH and other indicators, and the results were comparedRESULTS1.20cases of bacterial culture positive ascites in the SBP group, including culture of Escherichia coli in14cases,6cases of Klebsiella pneumoniae. Another6cases of ascites ascites bacterial culture negative.2、The levels of White blood cell count、TNF-a, IL-6, CRP in SBP ascites group were significantly higher than that in renal and malignant ascites group,(p<0.01or p<0.05). Compared with SBP and renal ascites group, the levels of VEGF, CEA, LDH in patients with malignant tumors were significantly increased (P<0.01)3, Sensitivity and specificity of ascitic fluid TNF-a(cut-off value>10ng/l) in discriminating infected ascites were73.6%and81.4%from non-infected ascites.accuracy was77.5%; Sensitivity and specificity of ascitic fluid CRP(cut-off value>10mg/l) in discriminating infected ascites were84.6%and78.9%from non-infected ascites,accuracy was81.8%respectively.4> Sensitivity and specificity of ascitic fluid VEGF(cut-off value>662ng/l) in discriminating malignant ascites were64.5%and92.1%from non-malignant ascites,accuracy was78.3%;Sensitivity and specificity of ascitic fluid CEA(cut-off value>5μg/l) in discriminating malignantascites were53.1%and94.7%from non-malignant ascites,accuracy was73.9%.5, The level of CRP in malignant ascite group was significantly higher than that in renal group,(p<0.01); The sensitivity and specificity of combined detection of VEGF, CEA, LDH for malignant ascites were90.3%and76.3%; The sensitivity and veracity of combined detection of TNF-a, IL-6, CRP were96.2%and72.1%. The sensitivity and specificity of combined detection of VEGF、CEA、LDH for malignant ascites were90.3%and76.3%. CONCLUTION1、The levels of TNF-a, IL-6, CRP in ascites might have a certain distinction value for diagnosis of SBP.2、The concentration of VEGF, CEA, LDH in ascites might contribute to distinguish benign ascites from malignant ascites.3、Optimal combination of multiple indicators can play a complementary strengths and improve the detection accuracy,which will help determine the character of ascites.