الفهرس 
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Abstract
Ascitic fluid analysis represents one of the most important procedures in evaluating the patients with ascites . Many biochemical parameters in ascitic fluid had been analyzed in attempt to differentiate between malignant and non malignant ascites (Rand et al., 2005).
Ascitic fluid Lactate dehydrogenase (LDH) isoenzymes have a very promising results in diagnosing the nature of ascites. In this study we examined 72 patients with ascites (( non malignant group (III) , n = 28 and malignancy related ascites , n = 44 . ”HCC related ascites group (I), n = 19 and non HCC related ascites group (II), n = 25” twenty six of the both group had positive cytology for malignant cells. i.e. malignant group)) to evaluate the usefulness of ascitic fluid LDH Isoenzymes differentiation between malignant and non malignant ascites . Ascitic fluid and serum of all patients were subjected to biochemical examination.
When we calculated the serum and asitic fluid of LDH , we founded that there was a higher mean serum LDH in malignant (group II) was 770.4±73.7 IU/L compared to other two groups and in HCC (Group I) was 476.7 ± 64.7 IU/L more than chronic liver diseases group (group III) 220.2 ± 35.9 IU/L and this is highly significant P.< 0.01 .
Ascitic fluid LDH recorded a higher mean in non HCC (group II) 594.8± 47IU/L compared tow other groups and in HCC (group I) 237.9 ± 39.6 IU/L more than chronic liver diseases (group III) 108.3 ± 15.6 IU/L
When we calculated the sensitivity, specifity and global accuracy of LDH and LDH isoenzymes ( LD1, LD2, LD3, LD4 and LD5) in all three studied groups , we detected at cut of value (290) in extra hepatic malignancy group (II) that serum LDH had specificity (100%) and sensitivity( 95.5% )with accuracy (97.2%) .