Ascitic Fluid Lactoferrin and Proinflammtory Cytokines (TNF-α and IL-6) for the Diagnosis of Spontaneous Bacterial Peritonitis

Tan-Hsia Chen ； Hui-Ling Chiou ； Ming-Chang Tsai ； Tzu-Wei Yang ； Hsuan-Yi Chen ； Chun-Che, Lin

《中山醫學雜誌》 27卷2期 (2016/12) Pp. 59-64

摘要

Purpose: Spontaneous bacterial peritonitis (SBP) is an important cause of morbidity and mortality in patients with cirrhosis and ascites . Fecal lactoferrin is a sensitive and specific marker for the differentiation of IBD and lBS and for the evaluation of disease activity of lBD. The aims of this study were to assess the utility of ascitic fluid lactoferrin concentration (AFLAC) for the diagnosis of SBP and evaluate the relationship between proinflammatory cytokines and SSP. Method: A total of III ascitic fluid samples from 66 patients were included in this study. Ascitic fluid samples were obtained from hospitalized patients for determination of cell counts, cultures, and lactoferrin, TNF-a, IL-6, and HsCRP concentrations. Receiver operating characteristic (ROC) curve was used to identify a cut-off level for future development of a rapid bedside test. Results: The percentage of SBP in ascitic fluid samples was 19.8%. The AFLAC concentration in SBP samples (mean, 5 1.23±34.3 4 ng/ml) was significantly higher than in non-SBP samples (mean, 18.44±18.98 ng/ml; P＜0.001). Only the area under the curve (AVC) of lactoferrin showed promising utility (0.788, 95% confidence interval, 0.670-0.907). The cut-off point of ascitic lactoferrin was 46 .07 ng/mL for distinguishing SBP and non-SSP samples. Conclusion: AFLAC can help in the diagnosis of SBP in cirrhotic patients. Further studies using larger numbers of samples should be performed to validate the utility of ascitic lactoferrin in diagnosing SSP.

關鍵字

Lactoferrin ； spontaneous bacterial peritonitis ； liver cirrhosis ； ascites ； cytokines