{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:01:22Z","timestamp":1792512082601,"version":"4.5.0"},"reference-count":55,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/medicina61091582","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:39:01Z","timestamp":1756744741000},"page":"1582","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Diagnostic Role of Tumor and Inflammatory Biomarkers in Ascitic Fluid: A Systematic Review"],"prefix":"10.3390","volume":"61","author":[{"given":"Gentiana","family":"Ratkoceri Hasi","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Clinical Biochemistry Clinic, University Clinical Center of Kosovo, 10000 Prishtina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1839-2415","authenticated-orcid":false,"given":"Jo\u0161ko","family":"Osredkar","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, 1525 Ljubljana, Slovenia"},{"name":"Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6748-7082","authenticated-orcid":false,"given":"Ale\u0161","family":"Jerin","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, 1525 Ljubljana, Slovenia"},{"name":"Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3748\/wjg.15.67","article-title":"Evaluation and management of patients with refractory ascites","volume":"15","author":"Senousy","year":"2009","journal-title":"World J. 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