Value of combined detection of AFU and TCH in differential diagnosis between malignant and non-tuberculous benign ascites

Abstract

The purpose of this study was to accurately evaluate the diagnostic efficacy of combined detection of ascitic fluid alpha-L-fucosidase (AFU) and cholesterol (TCH) compared with that of their individual detection. We assayed ascitic AFU activity by colorimetry and TCH level by CHOD-PAP method simultaneously in all 213 cases. Then, we assessed the value of combined detection of AFU and TCH activities with receiver operating characteristic curve (ROC curve), including diagnostic sensitivity, specificity, diagnostic accuracy, positive predict value(PV+), negative predict value(PV-) to see whether these two ascitic fluid biochemical examinations might help in differential diagnosis between malignant and non-tuberculous benign ascites. The mean values of AFU and TCH in malignant group [(164.96 ± 87.72) μmol/lh and (1.65 ± 1.00) mmol/l, respectively] were significantly higher than those in non-tuberculous benign group [(104.02 ± 62.08) μmol/lh and (0.69 ± 0.58) mmol/l, respectively] (P < 0.01). The optimal cutoff value of 101.95 μmol/lh for ascitic AFU and 1.04 mmol/l for ascitic TCH resulted in a diagnostic sensitivity of 82.3% and 70.8%, specificity of 63.2 and 83.8%, accuracy of 72.8 and 77.9%, PV+ of 65.3 and 78.2%, PV- of 83.1 and 77.8%, respectively. Combined detection of the two markers, the sensitivity, specificity, accuracy, PV+ and PV- were 86.5, 85.5, 85.9, 83.0, and 88.5%, respectively. Through comparison by Pearson Chi-square, the combined detection of AFU and TCH produced better diagnostic accuracy (85.9%) compared with the individual detection (P < 0.05). The combined detection of AFU and TCH produced better diagnostic accuracy in comparison with their individual detection, which is helpful to differential diagnosis between malignant and non-tuberculous benign ascites that may be relatively ideal markers to fit for clinical application in local hospitals.

Preoperative AFU Is a Useful Serological Prognostic Predictor for Colorectal Liver Oligometastasis Patients Undergoing Hepatic Resection

“…Another study showed that AFU in combination with CD26 can form a molecular model for diagnosis, especially for non-disseminated CRC 31. The combination of AFU and TCH can have better diagnostic accuracy in comparison with their individual detection ability, which is helpful for differential diagnosis between malignant and non-tuberculous benign ascites 32. In our study, we found that increased preoperative AFU in peripheral blood can predict better survival in CRLM patients undergoing hepatic resection.…”

Tumor Markers in Serum and Ascites in the Diagnosis of Benign and Malignant Ascites

“…It is said that no tumor marker has been found with high sensitivity and specificity in the malignant ascites induced by all causes. Some scholars (Zhang et al, 2011) believed that the combined detection of tumor markers in serum and ascites could improve their diagnostic values. This study mainly explored the values of tumor markers in serum and ascites as well as the ratios of ascites/serum in the identification and diagnosis of malignant ascites by analyzing the clinical data of patients diagnosed with ascites in our hospital in recent years.…”

To Study the Usefulness of Serum and Ascitic Fluid C-Reactive Protein (Crp) and Ascitic Fluid Cholesterol Level in Differential Diagnosis of Malignant, Nonmalignant and Tubercular Ascites

“…11 Papers about the detection of ascitic cholesterol have been published a lot and they have shown a relatively high diagnostic efficiency in differential diagnosis of MRA. 2,3 However, conflicting results have been reported and the exact role of ascitic fluid cholesterol concentration remains unclear.…”