Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Original Article

Volume 9, Number 1, February 2016, pages 17-21

New Biochemical Parameters in the Differential Diagnosis of Ascitic Fluids

Figures

Figure 1.
Figure 1. Immature lymphoid cells appearance (plasmablastic lymphoma involving stomach). Giemsa stain, × 1,000.
Figure 2.
Figure 2. Isolates neoplastic cells (gastric adenocarcinoma). Ascitic fluid. Giemsa stain, × 400.
Figure 3.
Figure 3. Isolates neoplastic cells (gastric adenocarcinoma). Ascitic fluid. PAP stain, × 400.

Tables

Table 1. Ascitic Etiologies
 
CausesPatients (%)
Exudates83 (55%)
  Infectious diseases34 (22%)
  Neoplasms29 (19%)
  Paraneoplastic effusions19 (12%)
    Gastric adenocarcinomas8
    Lymphomas7
    Colon adenocarcinoma2
    Esophagus adenocarcinoma2
  Neoplastic effusions10 (7%)
    Lymphomas3
    Gastric adenocarcinomas3 (1 Pap inconclusive, AgNOR > 14)
    Testicular germ cell carcinoma1
    Ovary adenocarcinoma1
    Renal clear cells carcinoma1
    Breast carcinoma1 (1 Pap inconclusive, AgNOR > 14)
Transudates69 (45%)
  Heart failure6 (4%)
  Cirrhosis45 (29%)
  Other pathologies18 (12%)

 

Table 2. Percentage of Patients With Transudates and Exudates Related to Cellularity and Biochemical Parameters
 
> 300 cells/mm3, n (%)> 500 cells/mm3, n (%)PT AF/S > 0.5, n (%)COL AF/S > 0.4, n (%)AST AF/S > 0.5, n (%)LDH AF/S > 0.6, n (%)ALT AF/S > 0.5, n (%)SAAG < 1.1, n (%)
T: transudate; E: exudate; SAAG: serum-ascites albumin gradient.
E (n = 83)65 (78)47 (57)60 (72)58 (70)66 (80)65 (78)58 (70)34 (41)
T (n = 69)2 (3)0 (0)12 (17)10 (15)10 (15)7 (10)13 (19)61 (88)
P value< 0.0001< 0.0001< 0.0001< 0.0001< 0.0001< 0.00010.0001< 0.0001

 

Table 3. Sensitivity, Specificity and Efficiency for Each Biochemical Parameter
 
Proposed parameterSensitivity (%)Specificity (%)Efficiency (%)P
> 300 cells/mm3789785< 0.0001
> 500 cells/mm35710079< 0.0001
AST AF/S > 0.5808581< 0.0001
LDH AF/S > 0.6789083< 0.0001
PT AF/S > 0.5728578< 0.0001
COL AF/S > 0.4708575< 0.0001
ALT AF/S > 0.57081740.0001