Peritoneal fluid analysis in the differentiation of ovarian cancer and benign ovarian tumor

Purpose: The aim of the study was to try to identify the biochemical marker s in peritoneal fluid which might be useful in discrimination between ovari an cancer and benign ovarian tumor. Methods: The study included 75 patients: 43 with invasive ovarian cancer, 6 with borderline ovarian cancer and 26 with benign ovarian tumor. The perit oneal fluid samples from all these patients were subjected to cytologic exa mination and to analysis of lactate dehydrogenase (LDH), total protein, alb umin and cholesterol. In addition, peritoneal fluid to serum ratio of LDH a nd total protein, as well as serum CA-125 were assayed. The biochemical par ameters were compared between cases of ovarian cancer and cases of benign o varian tumor, as well as between the different histological types and stage s of ovarian cancer. Results: All the examined parameters demonstrated a significant difference comparing patients with ovarian cancer and those with benign ovarian tumor (p<0.001). Yet, the greatest diagnostic accuracy was achieved by measuring peritoneal fluid LDH (86%) and cholesterol (93%). Moreover, significant dif ferences in the level of assayed parameters were found when comparing diffe rent histological types and stages of ovarian cancer. In order to further c orroborate the diagnostic performance, we combined the parameters of LDH an d cholesterol with cytology, thus increasing the diagnostic accuracy to 96% . Conclusion. The association of peritoneal fluid LDH and cholesterol may rep resent a primary tool for the discrimination of patients with ovarian cance r (even borderline) from those with benign ovarian tumor, particularly in t he presence of negative cytology.