Study of Cholesterol Levels in Ascitic Fluid to Differentiate Malignant from Non-Malignant Effusion.

Corresponding Author:
Dr. Rachna Sharma,
W/o. Dr. Vinay Sharma,
#185, Pawan Vihar,
Jain College Road, 4th Lane,
Ashram Riti Vidhyalam,
Saharanpur - 247001,
Uttar Pradesh, India.
E-mail: rachnasharmasre@gmail.com

ABSTRACT

BACKGROUND

Collection of more than normal quantity fluid in a serous cavity is called effusion. It is classified as per location i.e. pericardial, pleural and peritoneal. Fluid collection in abdominal cavity is called ascites. Effusions are of two types - (1) Transudate (2) Exudate. Transudate develops as a result of physiological disturbances of circulation usually a rise in venous pressure or decrease in oncotic pressure, while exudate forms as a result of increased capillary permeability which is usually due to inflammation. Transudates usually have low specific gravity due to low protein content whereas exudates have high specific gravity due to high protein content. Transudates are usually associated with cardiac-, hepatic- or renal-disease. While exudates are caused by inflammatory conditions like tuberculosis and malignancies of pelvic and abdominal organs. Recently fibronectin and cholesterol levels of peritoneal fluid have been found to differentiate between ascites of different aetiologies. The estimation of fibronectin levels in fluid is sensitive but complicated. So, in this study we have taken the value of cholesterol for the aetiologic diagnosis of ascites as a simple procedure.

METHODS

The present descriptive study of 100 cases of ascites was conducted over a period of 12 months i.e. January. 2019 to January 2020. Various fluids were collected from OPD and IPD of Medical and Surgery units.

RESULTS

In the present study, 84% of the cases were transudates while exudates accounted for 16% of cases. Cirrhosis (65%) was the commonest cause among transudates. Other causes included congestive cardiac failure (09%), nephrotic syndrome (06%), & anaemias (04%). Exudative ascites was caused by tuberculosis in 10% cases & malignancy in 06% cases. Cholesterol level of >70 mg/dL was found in 82% of malignant ascites. So, it was concluded that ascitic fluid cholesterol levels were significantly greater in malignant cases in comparison to ascites caused by non - malignant aetiologies. Inference - Cholesterol concentration in ascitic fluid helps to differentiate ascites in malignancy, from non - malignant ascites.

CONCLUSIONS

Cholesterol estimation in ascitic fluid is a better parameter to differentiate malignant ascites from non - malignant ascites.

KEY WORDS

Cholesterol, Ascites, Transudate, Exudate