Ascitic Fluid Hepatocyte Growth Factor: New Insights for Diagnosis of Spontaneous Bacterial Peritonitis in Cirrhotic Patients, an Egyptian Pilot Study
Background: Spontaneous bacterial peritonitis (SBP) is a common and potentially fatal complication of patients with decompensated cirrhosis and ascites. Hepatocyte growth factor (HGF) is a protein produced by mesenchymal cells including hepatocytes. It is regulated under different physiological and pathological conditions, for instance, during pregnancy, aging and infectious disease. This study focuses on evaluation of HGF as a local acute phase response marker in ascitic fluid of cirrhotic patient that could be used for early laboratory diagnosis of SBP. Methodology: Forty cirrhotic patients with SBP and 40 cirrhotic patients without SBP were included in this study. All involved patients were subjected to estimation of HGF level in the ascitic fluid using ELISA technique, in addition to conventional culture and biochemical reactions for identification of the bacteria involved of SBP. Results: There was a highly significant statistical difference in HGF levels in ascitic fluid between cirrhotic patients with SBP and those without SBP (P=0.000). The sensitivity and specificity of HGF for selective detection of the SBP group over the non-SBP group were 80 and 82.5%, respectively, at a cutoff value of 2981.34 pg/ml. There was a considerable positive correlation of HGF levels with TLC in ascitic fluid (r=0.372, p=0.018). There was a remarkable positive correlation between HGF levels and transaminases; AST and ALT (r=0.423, p=0.007 and r=0.359, P=0.023 respectively). Conclusion: HGF could be used as minimally invasive biomarker for early detection of SBP in cirrhotic patients.