ABSTRACT
Introduction: The excess accumulation of free fluid in the peritoneal cavity is due to its multitude causes. Certain cytological and biochemical markers are reported for the differential diagnosis of ascites. In the present study, ascitic patients with liver cirrhosis and ovarian carcinoma are investigated. Aim: To study the concentrations of certain trace elements and ceruloplasmin levels in ascitic fluid and in serum of patients with liver cirrhosis in comparison to ovarian cancer patients. Study Design: The study includes 170 patients with liver cirrhosis, 95 patients with ovarian cancer and 100 serum controls. Place and Duration of Study: The study is performed in the department of Gastroenterology, Osmania General Hospital Hyderabad, A.P, INDIA, between December 2011 to July 2013. Methodology: The trace elements such as magnesium, copper, zinc, iron and ceruloplasmin were investigated in 170 patients with liver cirrhosis (120 males, 50 females, 22-75 years; mean age 46.2±11.2) and 95 ovarian cancer patients (19-84 years; mean age 50.2±12.2). All the analysts were measured in serum and ascitic fluid by using standard commercial kits. 100 serum samples from healthy controls were also included in the study. Results: The mean serum concentrations of copper and ceruloplasmin were significantly increased in ovarian cancer patients when compared to that of liver cirrhosis and healthy controls (P<. 001, P<. 001) respectively. The mean zinc levels in serum samples were low in both the groups when compared to controls (P<. 001). The ascitic fluid zinc levels in ovarian cancer were higher when compared to that of liver cirrhosis (P<. 001). Similar results were noted in the serum iron levels in both the groups. The serum magnesium levels in liver cirrhosis are comparable to that of controls but the levels of magnesium in ovarian cancer ascitic patients are high when compared to that of controls. Conclusion: Our results showed that there are differences in trace elements and ceruloplasmin levels in liver cirrhosis and ovarian cancer patients in both serum and ascitic fluid samples. The cutoff value of copper and ceruloplasmin in serum samples are 134.5 μg/dl and 43.5 mg/dl, while in ascitic fluid were 46.5 μg/dl and 21.0 mg/dl respectively. As the diagnostic efficiency of copper and ceruloplasmin in serum and ascitic fluid samples are 97% to 99% with highest sensitivity and specificity, analysis of trace elements with ceruloplasmin in depth with their ratios may be helpful in differentiating the cirrhotic and neoplastic illness.