|Role of ascites adenosine deaminase in differentiating between tuberculous peritonitis and peritoneal carcinomatosis.|
|PMID: 22719194 Owner: NLM Status: MEDLINE|
|AIM: To investigate the usefulness of tumor markers and adenosine deaminase in differentiating between tuberculous peritonitis (TBP) and peritoneal carcinomatosis (PC).
METHODS: A retrospective analysis of data was performed on consecutive patients who underwent peritoneoscopic and abdominal computed tomography (CT) evaluations. Among 75 patients at the Seoul National University Hospital from January 2000 to June 2010 who underwent both tests, 27 patients (36.0%) and 25 patients (33.3%) were diagnosed with TBP and PC, respectively. Diagnosis was confirmed by peritoneoscopic biopsy.
RESULTS: Serum c-reactive protein (7.88 ± 6.62 mg/dL vs 3.12 ± 2.69 mg/dL, P = 0.01), ascites adenosine deaminase (66.76 ± 32.09 IU/L vs 13.89 ± 8.95 IU/L, P < 0.01), ascites lymphocyte proportion (67.77 ± 23.41% vs 48.36 ± 18.78%, P < 0.01), and serum-ascites albumin gradient (0.72 ± 0.49 g/dL vs 1.05 ± 0.50 g/dL, P = 0.03) were significantly different between the two groups. Among tumor markers, serum and ascites carcinoembryonic antigen, serum carbohydrate antigen 19-9 showed significant difference between two groups. Abdominal CT examinations showed that smooth involvement of the parietal peritoneum was more common in the TBP group (77.8% vs 40.7%) whereas nodular involvement was more common in the PC group (14.8% vs 40.7%, P = 0.04). From receiver operating characteristic (ROC) curves ascites adenosines deaminase (ADA) showed better discriminative capability than tumor markers. An ADA cut-off level of 21 IU/L was found to yield the best results of differential diagnosis; sensitivity, specificity, positive predictive value, and negative predictive value were 92.0%, 85.0%, 88.5% and 89.5%, respectively.
CONCLUSION: Besides clinical and radiologic findings, ascitic fluid ADA measurement is helpful in the differential diagnosis of TBP and PC.
|Seung Joo Kang; Ji Won Kim; Jee Hyun Baek; Se Hyung Kim; Byeong Gwan Kim; Kook Lae Lee; Ji Bong Jeong; Yong Jin Jung; Joo Sung Kim; Hyun Chae Jung; In Sung Song|
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|Type: Journal Article|
|Title: World journal of gastroenterology : WJG Volume: 18 ISSN: 2219-2840 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2012 Jun|
|Created Date: 2012-06-21 Completed Date: 2012-10-23 Revised Date: 2014-05-20|
Medline Journal Info:
|Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China|
|Languages: eng Pagination: 2837-43 Citation Subset: IM|
|APA/MLA Format Download EndNote Download BibTex|
Ascites / diagnosis*, etiology
Ascitic Fluid / enzymology*
Carcinoma / complications, diagnosis*
Clinical Enzyme Tests*
Peritoneal Neoplasms / complications, diagnosis*
Peritonitis, Tuberculous / complications, diagnosis*
Predictive Value of Tests
Republic of Korea
Sensitivity and Specificity
Tomography, X-Ray Computed
Tumor Markers, Biological / analysis*
|0/Tumor Markers, Biological; EC 188.8.131.52/ADA protein, human; EC 184.108.40.206/Adenosine Deaminase|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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