Ascitic Fluid Lactoferrin Investigated in Liver Cirrhosis Patients
By LabMedica International staff writers Posted on 03 Nov 2016 |
Image: A histopathology image of hepatocellular carcinoma: the malignant cells seen mostly on the right are well differentiated and interdigitate with normal, larger hepatocytes seen mostly at the left (Photo courtesy of SPL).
Although elevated levels of lactoferrin provide a biomarker for inflammatory bowel diseases and colorectal cancer, the clinical significance of these elevated levels in ascitic fluid of patients with ascites caused by liver cirrhosis is limited.
The usefulness of ascitic fluid lactoferrin levels for the diagnosis of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis has been investigated and the association between lactoferrin levels and the development of hepatocellular carcinoma (HCC) has been evaluated.
Doctors at the Gyeongsang National University Hospital (Jinju City, South Korea) consecutively enrolled 102 patients with ascites caused by cirrhosis were from December 2008 to December 2011. Liver cirrhosis was defined by the presence of portal hypertension manifested as splenomegaly, varices, ascites, or hepatic encephalopathy, with compatible findings on diagnostic imaging, in combination with thrombocytopenia of less than 100,000/μL). The diagnosis of SBP was based on a polymorphonuclear cells (PMN) count ≥250 cells/mm3 in ascitic fluid, with or without a positive ascitic fluid or blood culture.
Laboratory tests were performed for anti-hepatitis C virus (HCV), hepatitis B virus surface antigen (HBsAg), anti-hepatitis B virus surface antibody (anti-HBs), white blood cell (WBC) count, hemoglobin level, platelet count, prothrombin time- international normalized ratio (PT-INR), total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase, serum albumin, creatinine, CRP, and ascitic fluid analysis, including WBC count, PMN count, and albumin levels.
The lactoferrin level in ascitic fluid was quantified using a human lactoferrin enzyme-linked immunosorbent assay kit (Bethyl Laboratories, Inc., Tokyo, Japan). This kit, designed as a sandwich ELISA, captures human lactoferrin present in samples by anti-lactoferrin antibody that has been pre-adsorbed on the surface of polystyrene microtiter wells.
The scientists found that the median ascitic fluid lactoferrin levels were significantly higher in patients with SBP than in those without SBP (112.7 ng/mL versus 0.6 ng/mL). The area under the receiver operator characteristic curve for the diagnosis of SBP was 0.898 with a sensitivity and specificity for a cut-off level of 51.4 ng/mL of 95.8 % and 74.4 %, respectively. Moreover, the incidence of HCC in the 78 patients without SBP was significantly higher in patients with high ascitic fluid lactoferrin levels (≥35 ng/mL) than in those with low ascitic fluid lactoferrin level (<35 ng/mL).
The authors concluded that ascitic fluid lactoferrin level can be a useful diagnostic tool to identify SBP in patients with ascites caused by cirrhosis and elevated ascitic fluid lactoferrin level in patients without SBP may be indicative of a developing hepatocellular carcinoma. The study was published on October 13, 2016, in the journal BMC Gastroenterology.
Related Links:
Gyeongsang National University Hospital
Bethyl Laboratories
The usefulness of ascitic fluid lactoferrin levels for the diagnosis of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis has been investigated and the association between lactoferrin levels and the development of hepatocellular carcinoma (HCC) has been evaluated.
Doctors at the Gyeongsang National University Hospital (Jinju City, South Korea) consecutively enrolled 102 patients with ascites caused by cirrhosis were from December 2008 to December 2011. Liver cirrhosis was defined by the presence of portal hypertension manifested as splenomegaly, varices, ascites, or hepatic encephalopathy, with compatible findings on diagnostic imaging, in combination with thrombocytopenia of less than 100,000/μL). The diagnosis of SBP was based on a polymorphonuclear cells (PMN) count ≥250 cells/mm3 in ascitic fluid, with or without a positive ascitic fluid or blood culture.
Laboratory tests were performed for anti-hepatitis C virus (HCV), hepatitis B virus surface antigen (HBsAg), anti-hepatitis B virus surface antibody (anti-HBs), white blood cell (WBC) count, hemoglobin level, platelet count, prothrombin time- international normalized ratio (PT-INR), total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase, serum albumin, creatinine, CRP, and ascitic fluid analysis, including WBC count, PMN count, and albumin levels.
The lactoferrin level in ascitic fluid was quantified using a human lactoferrin enzyme-linked immunosorbent assay kit (Bethyl Laboratories, Inc., Tokyo, Japan). This kit, designed as a sandwich ELISA, captures human lactoferrin present in samples by anti-lactoferrin antibody that has been pre-adsorbed on the surface of polystyrene microtiter wells.
The scientists found that the median ascitic fluid lactoferrin levels were significantly higher in patients with SBP than in those without SBP (112.7 ng/mL versus 0.6 ng/mL). The area under the receiver operator characteristic curve for the diagnosis of SBP was 0.898 with a sensitivity and specificity for a cut-off level of 51.4 ng/mL of 95.8 % and 74.4 %, respectively. Moreover, the incidence of HCC in the 78 patients without SBP was significantly higher in patients with high ascitic fluid lactoferrin levels (≥35 ng/mL) than in those with low ascitic fluid lactoferrin level (<35 ng/mL).
The authors concluded that ascitic fluid lactoferrin level can be a useful diagnostic tool to identify SBP in patients with ascites caused by cirrhosis and elevated ascitic fluid lactoferrin level in patients without SBP may be indicative of a developing hepatocellular carcinoma. The study was published on October 13, 2016, in the journal BMC Gastroenterology.
Related Links:
Gyeongsang National University Hospital
Bethyl Laboratories
Latest Clinical Chem. News
- 3D Printed Point-Of-Care Mass Spectrometer Outperforms State-Of-The-Art Models
- POC Biomedical Test Spins Water Droplet Using Sound Waves for Cancer Detection
- Highly Reliable Cell-Based Assay Enables Accurate Diagnosis of Endocrine Diseases
- New Blood Testing Method Detects Potent Opioids in Under Three Minutes
- Wireless Hepatitis B Test Kit Completes Screening and Data Collection in One Step
- Pain-Free, Low-Cost, Sensitive, Radiation-Free Device Detects Breast Cancer in Urine
- Spit Test Detects Breast Cancer in Five Seconds
- Electrochemical Sensors with Next-Generation Coating Advances Precision Diagnostics at POC
- First-Of-Its-Kind Handheld Device Accurately Detects Fentanyl in Urine within Seconds
- New Fluorescent Sensor Array Lights up Alzheimer’s-Related Proteins for Earlier Detection
- Automated Mass Spectrometry-Based Clinical Analyzer Could Transform Lab Testing
- Highly Sensitive pH Sensor to Aid Detection of Cancers and Vector-Borne Viruses
- Non-Invasive Sensor Monitors Changes in Saliva Compositions to Rapidly Diagnose Diabetes
- Breakthrough Immunoassays to Aid in Risk Assessment of Preeclampsia
- Urine Test for Monitoring Changes in Kidney Health Markers Can Predict New-Onset Heart Failure
- AACC Releases Comprehensive Diabetes Testing Guidelines