ASCITIC LIPIDS AND ALBUMIN GRADIENT IN THE DIFFERENTIATION BETWEEN CIRRHOTIC AND MALIGNANT ASCITES IN NIGERIAN AFRICANS

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.