The correlation between cytological examination of ascitic fluid and serum ascites albumin gradient in the differential diagnosis of ascites

Abstract

Aim: The accumulation of fluid in pathological quantities in the peritoneal cavity is called ascites. In every newly diagnosed ascites, necessary investigations should be conducted by puncturing ascitic fluid. In this study, we aimed to investigate whether there is any correlation between cytological examination of ascitic fluid and serum ascites albumin gradient (SAAG) in the determination of etiologic causes of ascites. Material and Method: The files of the patients who were admitted to our clinic for the investigation of their ascites etiology between May 2014 and May 2018, were analyzed retrospectively. Pathology reports of the patients whose SAAG was calculated by taking the difference between serum albumin values and simultaneously taken ascitic fluid albumin and whose ascitic fluid cytology examination was performed, were recorded. The data of 248 patients with clinical diagnosis were included in the study. Patients with SAAG <1.1 g / dl and SAAG ≥1.1 g / dl, were divided into two groups. Results: Of the 248 patients included in the study, 114 were female (45.90%) and 134 were male (54.10%) patients. The patients were divided into 2 groups according to SAAG value. In group 1, there were 107 (43.14%) patients with SAAG <1.1 g / dl and in group 2, there were 141 (56.85%) patients with SAAG ≥1.1 g /dl. Group 1: In 70 (28.22%) of 107 patients, positive malignant cytology was consistent with ascites (p<0.0001). In 37 (14.91%) patients, benign cytology ascites was present. Group 2: 133 (53.62%) of 141 patients had benign cytology and 8 (3.23%) had malignant cytology. Conclusion: There was a correlation between malignant cytology of ascites with SAAG <1.1.