Ascitic Fluid Micro RNA 155 as a Biomarker for Spontaneous Bacterial Peritonitis

Abstract

Background : Spontaneous bacterial peritonitis is a life-threatening complication in cirrhotic ascitic patients. Objectives: We aimed to evaluate ascitic fluid microRNA155 level as diagnostic markers of (SBP) in association with Leukocyte esterase test, MPV, PDW, ascitic fluid CRP and culure. Methodology: A cross sectional study included 64 patients with ascites admitted to the Hepatology, Gastroenterology and Infectious diseases Department, Benha University Hospital, Egypt, divided into two groups: SBP group (32 pts.) and non SBP group (32 pts.).50 ml. of ascitic fluid was obtained for assessment of CRP, Leukocyte esterase test, bacterial culture and miR-155 and 12 ml blood for the routine laboratory test. Results : The AUC of miRNA 155 level was acceptable for discrimination between both groups (AUC=0.959), with cut off values 1.14pg/ml. Sensitivity 93.8%, specificity 93,7%, the cut-off value of ascitic fluid CRP was ≥12 ng/ml could predict SBP with sensitivity 81.3 % and specificity 81.2% , the Leucocyte esterase test cut-off value grade 1 and above could predict SBP with sensitivity 96.9 % , specificity of 84. %, accuracy of 90.6% ,with (AUC ) of 0.906, MPV and PDW could predict SBP with cut of ≥10.5% and 14.3fl , sensitivity of 84.4% and 59.4%% , and specificity of 84.4% and 62.5%% ,accuracy of 84.4 % and 60.9 %, the combined usage of rapid bed side tests including leucocyte esterase strips, ascitic fluid CRP, MPV and PDW could predict SBP in almost all cases Conclusion : MiR-155 Leukocyte esterase test, MPV, ascitic fluid CRP and culure were good diagnostic markers of SBP.