20.500.12556/DiRROS-29143 The diagnostic role of tumor and inflammatory biomarkers in ascitic fluid a systematic review Background and Objectives: Diagnosing the underlying cause of ascites remains complex, especially when cytology results are inconclusive. Measuring biomarkers directly in ascitic fluid may offer better diagnostic insight than serum testing alone. This review evaluated the clinical utility of tumor and inflammatory markers in ascitic fluid. Materials and Methods: A systematic search was conducted in PubMed and Scopus for studies published from January 2014 to December 2024, with the final search carried out in May 2025. The included studies were observational, comparative or biomarker validation studies evaluating ascitic fluid markers for diagnosing malignant and inflammatory ascites. The extracted outcomes included diagnostic accuracy metrics such as area under the curve (AUC), sensitivity and specificity. Risk of bias was evaluated using the ROBINS-I tool. Studies were excluded if they were case reports, animal studies, cytology-only analyses, or if they lacked biomarker data in ascitic or peritoneal fluid. Results: Forty-two studies met the inclusion criteria. CEA showed high diagnostic performance when measured in ascitic fluid. Combining markers or using ascitic-to-serum ratios improved diagnostic reliability. Inflammatory markers in ascitic fluid, such as CRP, IL-6 and VEGF added diagnostic value when cytology was inconclusive. Discussion and Conclusions: Evaluating biomarkers in ascitic fluid improved diagnostic accuracy. However, the included studies showed considerable methodological heterogeneity and moderate risk of bias. ascitic fluid CA125 CEA CRP diagnostic accuracy IL-6 inflammatory biomarkers malignant ascites tumor markers VEGF CRP diagnostična natančnost IL-6 vnetni biomarkerji maligni ascites tumorski markerji VEGF true false true Angleški jezik Slovenski jezik Neznano 2026-04-22 10:18:53 2026-04-22 10:18:53 2026-04-23 04:02:12 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 2. 9. 2025; str. 1-23 iss. 9, [article no.] 1582 Vol. 61 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616-074+576.3 1648-9144 10.3390/medicina61091582 247292931 RAZ_Ratkoceri_Hasi_Gentiana_2025.pdf RAZ_Ratkoceri_Hasi_Gentiana_2025.pdf 1 4F829AC4C57E68CDF8D1614AC9BE86D7 444aca264973a3e395925757790d2985b7b4b2156860c6bc4cf98cb0a647a106 00e96f14-3e24-11f1-a343-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43551 https://www.mdpi.com/1648-9144/61/9/1582 1 e6f0375b-3e23-11f1-a343-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43550 Univerzitetni klinični center Ljubljana 0 0 0