Uh. Malabu et al., ASCITIC LIPIDS AND ALBUMIN GRADIENT IN THE DIFFERENTIATION BETWEEN CIRRHOTIC AND MALIGNANT ASCITES IN NIGERIAN AFRICANS, Medical science research, 24(5), 1996, pp. 319-321
The purpose of this study was to investigate the efficacy of ascitic f
luid lipid analysis, and to compare it with albumin gradient and AF to
tal protein in discriminating between cirrhotic ascites and ascites ca
used by malignancies in Nigerian patients. 40 consecutive ascitic pati
ents, (22 with cirrhotic ascites and 18 with neoplasms metastatic to t
he peritoneum) were studied prospectively. The group with liver cirrho
sis (LC) consisted of non-alcoholics; 60 percent were hepatitis B surf
ace antigen positive. The patients with malignant ascites comprised fo
ur with ovarian carcinoma; three each of lymphoma, gastric and breast
carcinoma; two bronchogenic carcinoma; and one each of prostatic, test
icular and colon carcinoma. The results showed that AF cholesterol pro
vides excellent discrimination between the two types of ascites. Of fi
ve diagnostic parameters tested, AF cholesterol gave the best combinat
ion of results for the predictive value of a positive test and the pre
dictive value of a negative test. Determination of AF cholesterol and
albumin gradient are useful in differentiating ascites caused by malig
nancies from ascites due to LC. However, AF cholesterol measurement ma
y have considerable advantages in cost effectiveness.