Internal Medicine and Hepatology, Università Campus Bio-Medico, Roma, Lazio, Italy.
Unit of Electronics for Sensor Systems, Department of Science and Technology for Humans and the Environment, Università Campus Bio-Medico, Roma, Lazio, Italy.
PLoS One. 2020 May 21;15(5):e0233350. doi: 10.1371/journal.pone.0233350. eCollection 2020.
Serum-ascites albumin gradient (SAAG) remains the most sensitive and specific marker for the differentiation of ascites due to portal hypertension from ascites due to other causes. SAAG has some limitations and may fail in selected conditions. Voltammetric analysis (VA) has been used for the detection of electroactive species of biological significance and has proven effective for detection infections in biological fluids.
In this study, we compared the accuracy of voltammetric analysis (VA) with that of SAAG to differentiate ascites due to portal hypertension from that having a different origin.
80 ascites samples were obtained from patients undergoing paracentesis at the Campus Bio-Medico Hospital of Rome. VA was performed using the BIONOTE device. The ability of VA to discriminate ascitic fluid etiology and biochemical parameters was evaluated using Partial Least Square Discriminant Analysis (PLS-DA), with ten-fold cross-validations.
Mean age was 68.6 years (SD 12.5), 58% were male. Ascites was secondary to only portal hypertension in 72.5% of cases (58 subjects) and it was secondary to a baseline neoplastic disease in 27.5% of cases (22 subjects). Compared to SAAG≥1.1, e-tongue predicted ascites from portal hypertension with a better accuracy (92.5% Vs 87.5%); sensitivity (98.3% Vs 94.8%); specificity (77.3% Vs 68.2%); predictive values (PPV 91.9% Vs 88.7% and NPV 94.4% Vs 83.3%). VA correctly classified ascites etiology in 57/58 (98.2%) of cases with portal hypertension and in 17/22 (77.2%) of cases with malignancy. Instead, VA showed poor predictive capacities towards total white blood count and polymorphonuclear cell count.
According to this proof of concept study, VA qualifies as a promising low-cost and easy method to discriminate between ascites secondary to portal hypertension and ascites due to malignancy.
血清腹水白蛋白梯度（SAAG）仍然是鉴别由门静脉高压引起的腹水与由其他原因引起的腹水的最敏感和最特异的标志物。SAAG 有一些局限性，在某些情况下可能会失败。伏安分析（VA）已被用于检测生物意义上的电活性物质，并且已被证明对检测生物体液中的感染有效。
本研究比较了伏安分析（VA）与 SAAG 对鉴别由门静脉高压引起的腹水与由其他原因引起的腹水的准确性。
从罗马 Campus Bio-Medico 医院接受腹腔穿刺术的患者中获得 80 例腹水样本。使用 BIONOTE 设备进行 VA。使用偏最小二乘判别分析（PLS-DA）和十折交叉验证评估 VA 区分腹水病因和生化参数的能力。
平均年龄为 68.6 岁（标准差 12.5），58%为男性。仅在 72.5%的病例（58 例）中，腹水继发于单纯门静脉高压，而在 27.5%的病例（22 例）中，腹水继发于基线肿瘤疾病。与 SAAG≥1.1 相比，电子舌预测由门静脉高压引起的腹水具有更高的准确性（92.5%对 87.5%）；敏感性（98.3%对 94.8%）；特异性（77.3%对 68.2%）；预测值（PPV 91.9%对 88.7%和 NPV 94.4%对 83.3%）。VA 正确分类了 58 例门静脉高压患者中的 57 例（98.2%）和 22 例恶性肿瘤患者中的 17 例（77.2%）的腹水病因。相反，VA 对总白细胞计数和中性粒细胞计数的预测能力较差。
根据这项概念验证研究，VA 是一种有前途的低成本、易于使用的方法，可以鉴别由门静脉高压引起的腹水和由恶性肿瘤引起的腹水。
