Castaldo G, Intrieri M, Calcagno G, Cimino L, Budillon G, Sacchetti L, Salvatore F
Dipartimento di Biochimica e Biotecnologie Mediche, Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Italy.
Clin Chem. 1996 Nov;42(11):1843-6.
Various biochemical indexes discriminate neoplastic from nonneoplastic ascites. However, within the latter group, the distinction between cirrhotic ascites and ascites caused by hepatocarcinoma (HC) is usually based on liver biopsy or cytology. HC-derived ascites is included in the group of nonneoplastic ascites because it is not associated with peritoneal spreading of neoplastic cells. In 54 cases of cirrhotic ascites and 17 cases of HC ascites, all histologically diagnosed, ascitic pseudouridine concentrations discriminated cirrhotic from HC ascites. For example, using the cutoff value of 4.25 mumol/L (obtained by ROC curve analysis) resulted in a diagnostic sensitivity of 88.2% and a diagnostic specificity of 90.8%. Moreover, in cirrhosis, the ascitic concentrations of pseudouridine were lower than serum concentrations, and the two sets of values were correlated; in HC, however, ascitic pseudouridine concentrations were higher than serum concentrations, and the two were unrelated. These findings strongly suggest that in cirrhotic patients ascitic pseudouridine derives from serum by diffusion, whereas in HC patients the mechanism appears to be more complex.
多种生化指标可区分肿瘤性腹水和非肿瘤性腹水。然而，在非肿瘤性腹水组中，肝硬化腹水与肝癌（HC）所致腹水的区分通常基于肝活检或细胞学检查。HC来源的腹水被归入非肿瘤性腹水组，因为它与肿瘤细胞的腹膜播散无关。在54例经组织学确诊的肝硬化腹水病例和17例HC腹水病例中，腹水中假尿苷浓度可区分肝硬化腹水和HC腹水。例如，使用通过ROC曲线分析得到的4.25 μmol/L的临界值，诊断敏感性为88.2%，诊断特异性为90.8%。此外，在肝硬化中，腹水中假尿苷浓度低于血清浓度，且两组值相关；然而，在HC中，腹水中假尿苷浓度高于血清浓度，且两者不相关。这些发现强烈表明，在肝硬化患者中，腹水中的假尿苷通过扩散来源于血清，而在HC患者中，其机制似乎更为复杂。
