Diagnostic accuracy of ascitic cholesterol concentration for malignant ascites: a meta-analysis

Many studies have investigated whether ascitic cholesterol can aid in diagnosis of malignant related ascites (MRA), and the results have varied considerably. To gain a more reliable answer to this question, we meta-analyzed the literature on using ascitic cholesterol as diagnostic tests to help identify MRA. Literature databases were systematically searched for studies examining accuracy of ascitic cholesterol for diagnosing MRA. Data on sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR), and diagnostic odds ratio (DOR) were pooled using random effects models. Summary receiver operating characteristic (SROC) curves and area under the curve (AUC) were used to summarize overall test performance. At last, our meta-analysis included 8 studies involving 743 subjects. Summary estimates for ascitic cholesterol in the diagnosis of MRA were as follows: sensitivity, 0.82 (95% CI 0.78 to 0.86); specificity, 0.90 (95% CI 0.87 to 0.93); PLR, 9.24 (95% CI 4.58 to 18.66); NLR, 0.16 (95% CI 0.08 to 0.32); and DOR, 66.96 (95% CI 18.83 to 238.11). The AUC was 0.96. The ascitic cholesterol level is helpful for the diagnosis of MRA. Nevertheless, the results of ascitic cholesterol assays should be interpreted in parallel with the results of traditional tests and clinical information.