Diagnostic Importance of Ascitic Fluid Cholesterol Level in the Diagnosis of Malignant Ascites

Authors: Mehmet ARSLAN, Halis ŞİMŞEK, Murat GÜRSOY, Abdurrahman KADAYIFÇI, Hasan TELATAR

Abstract: In order to evaluate the diagnostic accuracy of cholesterol level in ascites, we studied 27 patients with non-complicated sterile ascites (group l), 12 patients with spontaneous bacterial peritonitis (group ll), and 17 patients with malignant ascites (group lll). The median cholesterol level in ascitic fluid was 0.44 mmol/L (lQR 0.62) in group l, 0.25 mmol/L (lQR 0.95) in group ll, and 2.61 mmol/L (lQR 2.66) in group lll. The ascitic fluid cholesterol level was significantly higher in malignant ascites than sterile benign ascites and spontaneous bacterial peritonitis (SBP) (P<0.05). However, no significant difference was found between sterile benign ascites and ascites with spontanous bacterial peritonitis. the diagnostic accuracy of ascites cholosterol concentration for discriminating malignant ascites was 93%. In conclusion, this study shwos that cholesterol level in ascites cen be used as a valuable test in differentiating malignant ascites from cirrhotic ascites.

Keywords: ascites, cancer, spontaneous bacterial peritonitis, cholesterol