Introduction: Simple test(s) on ascitic fluid or serum which can help differentiate between Malignancy and Non-Malignancy Related ascites is a challenge that is not always met satisfactorily.

Aim: The purpose of this study is to assess the usefulness of Ascitic Fluid C-Reactive Protein (CRP) in differential diagnosis of Ascites.

Methodology: This prospective study included 80 patients with Ascites, admitted to Medical Gastroenterology Department of Madras Medical College, from January 2018 to January 2019. The patients were divided into two groups – Malignant ascites (n=30) and Non-malignant Ascites (n=50). The modalities for selecting malignant group were either cytology/ peritoneal biopsy positive cases. Complete Blood Count, LFT, Ascitic Fluid Analysis including Total Protein, albumin, cholesterol, CRP, culture & sensitivity, Total and differential counts were done in all patients. USG abdomen, upper GI endoscopy, CECT abdomen, ADA, FNAC of peritoneal nodules and liver biopsy were performed in selected cases. Bacterial peritonitis was excluded in all these patients.Serum and ascitic fluid CRP were analyzed in all cases. Data were entered in Microsoft Excel and analyzed using IBM SPSSS (Ver. 20.0)

Results: Mean value of Ascitic Fluid CRP were significantly higher in Malignancy group than Non-malignancy group (16.6±13.4 vs 2.1±3.2 ng/ml) (p value 0.001). Serum CRP was also significantly higher in malignant ascites than benign ascites patients [10.8±6.3 mg/ml vs. 6.2±4.9 mg/ml;p<0.001].

Conclusion: Elevated ascitic fluid and serum CRP values can be used to differentiate malignancy related ascites from benign ascites.

Keywords: Ascites; Ascitic Fluid; CRP; C-reactive protein; Malignant.

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Jinsha K. A

Institute of Medical Gastroenterology, Madras Medical College, The Tamil Nadu Dr. M.G.R Medical University, Chennai, India