Ahmed Abdel-Razik1, Nasser Mousa2, Hatem Elalfy2, Tarek Fouad Sheta3, Mahmoud Awad3, Mostafa Abdelsalam4, Rania Elhelaly5, Rasha Elzehery5, Nawal S Gouda6, Waleed Eldars6. 1. Tropical Medicine Department, Faculty of Medicine, Mansoura University-Egypt, Mansoura, 35516, Egypt. Ahmedabdelrazik76@gmail.com. 2. Tropical Medicine Department, Faculty of Medicine, Mansoura University-Egypt, Mansoura, 35516, Egypt. 3. Internal Medicine Department, Faculty of Medicine, Mansoura University-Egypt, Mansoura, Egypt. 4. Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University-Egypt, Mansoura, Egypt. 5. Clinical Pathology Department, Faculty of Medicine, Mansoura University-Egypt, Mansoura, Egypt. 6. Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University-Egypt, Mansoura, Egypt.
Abstract
BACKGROUND AND AIMS: Ascites with unknown cause remains a diagnostic challenge, which needs novel noninvasive biomarkers for the precise diagnosis. We aimed to evaluate the ascitic fluid and serum C-reactive protein (CRP) and vascular endothelial growth factor (VEGF) as diagnostic markers in the differential diagnosis of malignant and benign ascites. METHODS: In this prospective work, 315 consecutive patients with ascites were studied. Ascitic fluid and serum levels of CRP and VEGF were evaluated by using an enzyme-linked immunosorbent assay. RESULTS: Patients were divided into a benign ascites group (group 1) (n = 256) and a malignant ascites group (group 2) (n = 59). Ascitic and serum CRP were significantly elevated in malignant ascites than benign ascites group [5.08 (3.62-6.58) vs. 1.82 (0.64-3.86) ng/ml; P < 0.001 and 12.7 (8.55-17.05) vs. 5.94 (2.57-10.64) ng/ml; P < 0.001], respectively. Ascitic and serum VEGF were significantly increased in malignant ascites than benign ascites patients [0.68 (0.39-0.96) vs. 0.41 (0.25-0.83) ng/ml; P < 0.001 and 0.74 (0.41-1.08) vs. 0.54 (0.23-0.86) ng/ml; P < 0.001], respectively. At a cutoff value of 7.3 and 0.63 ng/ml, serum CRP and VEGF had specificity (77.3 and 89.5 %) and sensitivity (83.1 and 94.9 %) for detecting malignant ascites [area under the curve (AUC) 0.821, 0.921], respectively. At a cutoff value of 2.5 and 0.57 ng/ml, ascitic CRP and VEGF had specificity (81.6 and 85.5 %) and sensitivity (84.7 and 91.5 %) for detecting malignant ascites (AUC 0.842, 0.894), respectively. CONCLUSION: Elevated ascitic fluid and serum CRP and VEGF values were related to the malignant ascites.
BACKGROUND AND AIMS: Ascites with unknown cause remains a diagnostic challenge, which needs novel noninvasive biomarkers for the precise diagnosis. We aimed to evaluate the ascitic fluid and serum C-reactive protein (CRP) and vascular endothelial growth factor (VEGF) as diagnostic markers in the differential diagnosis of malignant and benign ascites. METHODS: In this prospective work, 315 consecutive patients with ascites were studied. Ascitic fluid and serum levels of CRP and VEGF were evaluated by using an enzyme-linked immunosorbent assay. RESULTS:Patients were divided into a benign ascites group (group 1) (n = 256) and a malignant ascites group (group 2) (n = 59). Ascitic and serum CRP were significantly elevated in malignant ascites than benign ascites group [5.08 (3.62-6.58) vs. 1.82 (0.64-3.86) ng/ml; P < 0.001 and 12.7 (8.55-17.05) vs. 5.94 (2.57-10.64) ng/ml; P < 0.001], respectively. Ascitic and serum VEGF were significantly increased in malignant ascites than benign ascitespatients [0.68 (0.39-0.96) vs. 0.41 (0.25-0.83) ng/ml; P < 0.001 and 0.74 (0.41-1.08) vs. 0.54 (0.23-0.86) ng/ml; P < 0.001], respectively. At a cutoff value of 7.3 and 0.63 ng/ml, serum CRP and VEGF had specificity (77.3 and 89.5 %) and sensitivity (83.1 and 94.9 %) for detecting malignant ascites [area under the curve (AUC) 0.821, 0.921], respectively. At a cutoff value of 2.5 and 0.57 ng/ml, ascitic CRP and VEGF had specificity (81.6 and 85.5 %) and sensitivity (84.7 and 91.5 %) for detecting malignant ascites (AUC 0.842, 0.894), respectively. CONCLUSION: Elevated ascitic fluid and serum CRP and VEGF values were related to the malignant ascites.
Authors: M S Loewenstein; R A Rittgers; A E Feinerman; H Z Kupchik; B R Marcel; R S Koff; N Zamcheck Journal: Ann Intern Med Date: 1978-05 Impact factor: 25.391
Authors: Aristotelis Bamias; Vasiliki Koutsoukou; Evangelos Terpos; Marinos L Tsiatas; Christina Liakos; Ourania Tsitsilonis; Alexandros Rodolakis; Zannis Voulgaris; G Vlahos; Theocharis Papageorgiou; G Papatheodoridis; A Archimandritis; A Antsaklis; M A Dimopoulos Journal: Gynecol Oncol Date: 2007-11-26 Impact factor: 5.482