Abstract
In a perspective study, the ascitic fluid and serum concentration of total cholesterol, total proteins and albumin in a group of 45 patients was studied. Patients with nonmalignant or cirrhotic ascites were compared with patients having malignancy related ascites and it was proved that the ascitic fluid cholesterol and the serum ascites albumin gradient helped to differentiate cirrhotic from malignant ascites. These two parameters showed a remarkable relationship to the presence/absence of malignancy. Non malignant ascites patients had ascitic fluid cholesterol values of 19.41±8.33 mg/dl, as against the malignancy related ascites patients, who showed levels of 95.87±1.24 mg/dl. Similarly, the serum-ascites albumin gradient levels were 2.89±0.65 in non malignant ascites patients, while the malignancy related ascites cases had 0.86±0.50. The discrimination values for cholesterol were taken as 45 mg/dl while that for serum ascites gradient was taken as 1.1. Levels of serum cholesterol, total protein and albumin were not significantly altered.
Keywords: Malignancy related ascites, nonmalignant ascites, cholesterol, serum-ascites albumin gradient
Full Text
The Full Text of this article is available as a PDF (338.2 KB).
References
- 1.Garrison R.N., Kaelin L.D., Galloway R.H., Heuser L.S. Malignant ascites: Clinical and experimental observation. Ann. Surg. 1986;203:644–644. doi: 10.1097/00000658-198606000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Jungst D. Gerbe, Alexander J.D., Robert A.L., Martin R. Gustav, Paimgartner G. Value of ascitic lipids in differentiation between cirrhotic and malignant ascites. Hepatology. 1986;6:239–243. doi: 10.1002/hep.1840060214. [DOI] [PubMed] [Google Scholar]
- 3.Varley H. Lipids and lipoproteins. In: Gowenlock A.H., editor. Practical Clinical Biochemistry. 6th edn. London: Heineman Medical Books; 1988. pp. 452–476. [Google Scholar]
- 4.Varley H. Plasma proteins. In: Gowenlock A.H., editor. Practical Clinical Biochemistry. 6th edn. London: Heineman Medical Books; 1988. pp. 401–435. [Google Scholar]
- 5.Wooton I.D.P., Freeman H. Microanalysis in Medical Biochemistry. 6th edn. London: Churchill Livingstone; 1982. Proteins; pp. 145–145. [Google Scholar]
- 6.Runyon B.A., Hoefs J.C., Morgan T.R. Ascitic fluid analysis in malignancy related ascites. Hematology. 1998;8:1104–1109. doi: 10.1002/hep.1840080521. [DOI] [PubMed] [Google Scholar]
- 7.Halperin R., Hadas E., Bukovsky I., Schneider D. Peritoneal fluid analysis in the differentiation of ovarian cancer and benign ovarian tumor. Eur-J-Gynaecol-Oncol. 1999;20(1):40–44. [PubMed] [Google Scholar]
- 8.Bansal S., Kaur K., Bansal A.K. Diagnosing ascitic etiology on a bio chemical basis. Hepatogastroenterology. 1998;45(23):1673–1677. [PubMed] [Google Scholar]
- 9.Castaldo G., Oriani G., Cimino L., Topa M., Mostarda I., Castallano L. Total discrimination of peritoneal malignant ascites from cirhosis—and hepatocarcinoma— associated ascites by assays of ascitic cholesterol and lactate dehydrogenase. Clin-Chem. Mar. 1994;40(3):478–483. [PubMed] [Google Scholar]
- 10.Garg R., Sood A., Arora S., Bhatia K.L., Chawla L.A., Gupta R., Chawla L.S. Ascitic fluid cholesterol in differential diagnosis of ascites. J. Assoc. Physicians. India. 1993;41(10):644–646. [PubMed] [Google Scholar]
- 11.Sood A., Garg R., Kumar R., Chinna R.S., Arora S., Gupta R., Bhatia K.L. Ascitc fluid cholesterol in malignant and tubercular ascites. J. Assoc. Physicians India. Nov. 1985;43(11):745–747. [PubMed] [Google Scholar]
- 12.Feldman G.B., Knapp R.C. Lymphatic drainage of the peritoneal cavity and its significance in ovarian cancer. Amer. J. Obstet. Gynecol. 1974;119(7):991–994. doi: 10.1016/0002-9378(74)90021-0. [DOI] [PubMed] [Google Scholar]
- 13.Coates G., Bush R.S., Aspin N. A study of ascites using lymphoscintiography with99mTc-sulfur colloid. Radiology. 1973;107:577–583. doi: 10.1148/107.3.577. [DOI] [PubMed] [Google Scholar]
- 14.Goyal A.K., Goyal S.K., Pokhrana D.S., Sharma S.K. Differential diagnosis of ascitic fluid: Evaluation and comparison of various biochemical criteria with a special reference to serum ascites albumin concentration gradient and its relation to portal pressure. Tropical Gastroenterology. 1989;10(1):51–55. [PubMed] [Google Scholar]
- 15.Ghilian J.M., Henrion J., Scharpira M., Majois F., Beaudin M., Heller F.R. Ascitic fluid: The value of various biological tests in the differential diagnosis between cirrhotic and neoplastic ascites. Acta Gastroenterol Belg. 1990;52(2):168–179. [PubMed] [Google Scholar]