Yildirim, BSari, RIsci, N2024-08-042024-08-0420050027-96841943-4693https://hdl.handle.net/11616/93808Background: Cytokines play a key role in the regulation of cells of the immune system and also have been implicated in the pathogenesis of malignant diseases. Method and Patients: We studied tumor necrosis factor-cl, tumor necrosis factor receptor and C-reactive protein levels in both ascitic fluid and serum in patients with spontaneous bacterial peritonitis (SBP) (n=22), and in the malignant (n=38) and cirrhotic (n=32) ascites. Results: C-reactive protein, tumor necrosis factor-a and tumor necrosis factor receptor levels in the ascitic fluid were found to be elevated in the SBP (p<0.001) and malignant groups (p<0.005) when compared with the sterile cirrhotic group. C-reactive protein levels in the serum were found to be elevated in the SBP group when compared with the sterile cirrhotic (p<0.001) and malignant group (p<0.005). Tumor necrosis factor-a in the serum was significantly elevated in the SBP when compared with the cirrhotic (p<0.005) and malignant ascites (p<0.001). Sensitivity and specificity of ascitic fluid CRP in discriminating malignant 84% and 67% and SBP from sterile ascites were 90% and 76%, respectively. Sensitivity and specificity of ascitic fluid TNF-alpha in discriminating malignant 77% and 60% and SBP from sterile ascites were 82% and 66%, respectively. Sensitivity and specificity of TNF-r p60 in discriminating malignant 74% and 70% and SBP from sterile ascites were 80% and 76%, respectively. Conclusion: The sensitivity and specificity of ascitic fluid CRP, TNF-alpha and TNF-r values were found to be similar. Ascitic fluid C-reactive protein to differentiate SBP and malignant ascitic from cirrhotic ascites are cheap, practical and safe tests used in the differential diagnosis of ascites.eninfo:eu-repo/semantics/closedAccessascitesdiagnosistumor necrosis factortumor necrosis factor receptorCRPArticle972276280157127922-s2.0-13444270449Q1WOS:000226701600039Q3