Value of combined detection of AFU and TCH in differential diagnosis between malignant and non-tuberculous benign ascites

The purpose of this study was to accurately evaluate the diagnostic efficacy of combined detection of ascitic fluid alpha-l-fucosidase (AFU) and cholesterol (TCH) compared with that of their individual detection. We assayed ascitic AFU activity by colorimetry and TCH level by CHOD-PAP method simultaneously in all 213 cases. Then, we assessed the value of combined detection of AFU and TCH activities with receiver operating characteristic curve (ROC curve), including diagnostic sensitivity, specificity, diagnostic accuracy, positive predict value(PV+), negative predict value(PV−) to see whether these two ascitic fluid biochemical examinations might help in differential diagnosis between malignant and non-tuberculous benign ascites. The mean values of AFU and TCH in malignant group [(164.96 ± 87.72) μmol/lh and (1.65 ± 1.00) mmol/l, respectively] were significantly higher than those in non-tuberculous benign group [(104.02 ± 62.08) μmol/lh and (0.69 ± 0.58) mmol/l, respectively] (P < 0.01). The optimal cutoff value of 101.95 μmol/lh for ascitic AFU and 1.04 mmol/l for ascitic TCH resulted in a diagnostic sensitivity of 82.3% and 70.8%, specificity of 63.2 and 83.8%, accuracy of 72.8 and 77.9%, PV+ of 65.3 and 78.2%, PV− of 83.1 and 77.8%, respectively. Combined detection of the two markers, the sensitivity, specificity, accuracy, PV+ and PV− were 86.5, 85.5, 85.9, 83.0, and 88.5%, respectively. Through comparison by Pearson Chi-square, the combined detection of AFU and TCH produced better diagnostic accuracy (85.9%) compared with the individual detection (P < 0.05). The combined detection of AFU and TCH produced better diagnostic accuracy in comparison with their individual detection, which is helpful to differential diagnosis between malignant and non-tuberculous benign ascites that may be relatively ideal markers to fit for clinical application in local hospitals.