LC : Usefulness of Ascitic Fluid Lactoferrin Concentration for the Diagnosis of Spontaneous Bacterial Peritonitis = LC : Usefulness of Ascitic Fluid Lactoferrin Concentration for the Diagnosis of Spontaneous Bacterial Peritonitis

다국어 초록 (Multilingual Abstract)

Background: Spontaneous bacterial peritonitis (SBP) is one of major complications in patients with liver cirrhosis, early diagnosis and treatment of the disease is crucial for reducing mortality. Lactoferrin, an iron-binding protein usually detected in polymorphonuclear neutrophils or exocrine fluid such as breast milk, is known for contributing to the antimicrobial activity of leukocytes to protect our body from enteric bacteria. We aimed to determine the validity of lactoferrin concentration in ascitic fluid for the diagnosis of SBP. Subjects and Methods: We collected ascitic fluid through diagnostic or therapeutic paracentesis from the hospitalized individuals with liver cirrhosis and measured lactoferrin concentration from October, 2008 to March, 2011. A total of 201 specimens from 148 patients were collected for analysis and the concentration of lactoferrin in ascites was calculated by enzyme- linked immunosorbent assay. We compared the concentrations of lactoferrin in ascitic fluid obtained from the cirrhotic patients with and without SBP, and aimed to determine the usefulness of lactoferrin concentration as a diagnostic method for SBP. Results: A total of 53 patients diagnosed with SBP represented higher level of lactoferrin concentration in ascites than the patients without SBP (107.48±40.74 ng/mL vs. 19.97±40.74 ng/ mL, P<0.01). Applying 60 ng/mL of lactoferrin in ascites as a cut-off value for the diagnosis of SBP produced the sensitivity, specificity, positive predictive value and negative predictive value, 90.6%, 75.7%, 57.1% and 95.7%, respectively. Conclusion: The concentration of lactoferrin in ascitic fluid was a rapid and reliable test for the diagnosis of SBP in cirrhotic patients with ascites.