Ascitic fluid cholesterol in malignant ascites a tumor marker and diagnostic tool

ABSTRACT

The present study was undertaken to evaluate the use of ascitic fluid cholesterol determination in the differentiation between malignant and cirrhotic ascites. Again, the aim of our study was to further illustrate the value of estimating serum-ascites albumin gradient in differentiating ascites due to cirrhosis from that due to malignancy. This study was carried out on two groups of ascitic patients, the first with cirrhotic ascites and included 13 patients, the second with malignant ascites and included 19 patients. Ascitic fluid cholesterol level was found to be significantly higher in malignant group than in cirrhotic group. Ascitic fluid cholesterol above 48 mg percent was found to have high sensitivity [77.81 percent], high specificity [92.85 percent] and to have the highest diagnostic accuracy [84.37 percent] among all chemical tests used for diagnosis of malignant ascites [namely total proteins; LDH and s-a albumin difference. In evaluating the serum ascites albumin difference, it was found to be significantly lower in malignant than cirrhotic group [P < 0.01]. The diagnostic accuracy with s-a albumin difference < 1.1 gm percent was higher than that with total proteins >3 gm percent. Pare et al, 1983 reported that s-a Albumin was a useful tool in differentiating ascites due cirrhosis from that due to malignancy. Hoef [1981 b] reported stability of the gradient during diuresis