SIGNIFICANCE OF ASCITIC FLUID FERRITIN & LDH IN DIFFERENTIATING MALIGNANCY RELATED ASCITES FROM BENIGN ASCITES

Jinsha K. A; R Murali; A. R Venkateswaran

Volume : VIII, Issue : VI, June - 2019

SIGNIFICANCE OF ASCITIC FLUID FERRITIN & LDH IN DIFFERENTIATING MALIGNANCY RELATED ASCITES FROM BENIGN ASCITES

Jinsha K. A, R Murali, A. R Venkateswaran

Abstract :

Introduction: Simple test(s) on ascitic fluid or serum which can help differentiate between Malignancy and Non–Malignancy Related ascites is a challenge that is not always met satisfactorily. Aim: The purpose of this study is to assess the usefulness of Ascitic Fluid Ferritin and Ascitic Fluid Lactate Dehydrogenase (LDH) in differential diagnosis of Ascites. Methodology: This prospective study included 80 patients with Ascites, admitted to Medical Gastroenterology Department of Madras Medical College, from January 2018 to January 2019. The patients were divided into two groups – Malignant ascites (n=30) and Non–malignant Ascites (n=50). The modalities for selecting malignant group were either cytology/ peritoneal biopsy positive casescdsa z . Serum and ascitic fluid ferritin and LDH were analyzed in all cases. Bacterial peritonitis was excluded in all these patients. Data were entered in Microsoft Excel and analyzed using IBM SPSSS (Ver. 20.0) Results: Mean value of Ascitic Fluid Ferritin were significantly higher in Malignancy group than Non–malignancy group (1108.3�1236.2 vs 117.5�115.6 ng/ml) (p value 0.001). In the malignant group, mean value of LDH was 659.9�304.5 IU/ml, and in benign group it was 93.4�64.9 IU/ml (p value 0.001). Ferritin at a cut off value of ≥350 has a sensitivity of 90% and specificity of 92% and LDH at a cut off value of ≥150 has 90% sensitivity and specificity for differentiating malignant and benign ascites. Conclusion: Ascitic fluid Ferritin and LDH, which are simple, easily available and cost–effective markers, can be used to differentiate Malignancy Related Ascites from Non–malignant Ascites.