Περίληψη:
Our objectives were to study the value of different proteins in the
serum and ascitic fluid and assess their potential in discriminating
between malignant and nonmalignant ascites in a model that could be
developed to aid clinical diagnosis. In all, 57 different measurements
(30 in serum and 27 in ascitic fluid) including erythrocyte
sedimentation rate, number of white blood cells, cytokines,
interleukin-la (IL-1a), IL-lb, IL-2, IL-G! IL-8, tumor necrosis
factor-alpha, immunoglobulins (IgG, IgA, IgM), complement factors C3 and
C4, acute-phase proteins such as alpha(1)-acid glycoprotein,
alpha(2)-macroglobulin, alpha(1)-antitrypsin, haptoglobin, C-reactive
protein, ferritin, cerulo-plasmin and transferin, were performed in 61
patients with ascites (25 with malignant exudates, 13 with nonmalignant
exudates, and 23 with transudates). Patients with sepsis were excluded.
Correlation tests and one-way ANOVAs were used for comparisons between
different groups. Discriminant analyses were used to assess the
significance of each parameter in the differentiation process. Correct
classification of 100% of cases required the use of all 57 ascitic
fluid measurements in the model, which was not considered practical in
clinical diagnosis. Discriminant analysis showed that five ascitic fluid
measurements-total protein, LDH, TNF-alpha, C4, and haptoglobin-were
sufficient for a model to correctly classify 89% of cases.
Cross-validation showed that 70% of unknown cases were correctly
classified using this model. In conclusion, we have shown that five
easily taken protein measurements in the ascitic fluid can differentiate
to a large extent between eases with ascites and have proposed a
relatively simple statistical model with these parameters that could be
developed to be extremely useful in the clinical setting.
Συγγραφείς:
Alexandrakis, MG
Moschandrea, JA
Koulocheri, SA
Kouroumalis,
E
Eliopoulos, GD
