Telomerase assay for differentiating between malignancy-related and nonmalignant ascites

The differential diagnosis between malignancy-related ascites (MRAs) and no nmalignant ascites (NMAs) has remained an essential problem in clinical pra ctice. Our purpose was to determine the diagnostic value of ascitic fluid t elomerase activity in discriminating these two categories compared with tha t of cytological examination. Twenty-five MRAs and 47 NMAs as the control g roup were enrolled in our study. In the MRA group, telomerase activity was detected in 13 of 16 (81.3%) cases of peritoneal carcinomatosis and in 6 of 9 (66.7%) cases of hepatocellular carcinoma (HCC)-associated ascites, Cont rasting that, cytological examination was positive in only 9 of 16 (56.3%) and 1 of 9 (11.1%) cases, respectively. In the NMA group, telomerase-positi ve ascitic fluid samples were found in 2 of 47 (4.3%) cases, all belonging to subgroups that contained large numbers of lymphocytes in the ascites, In our study, the telomerase activity and cytological examination exhibited a sensitivity of 76% and 40% and a specificity of 95.7% and 100%, respective ly. Regarding subgroups of MRAs, the telomerase activity and cytological ex amination demonstrated a sensitivity of 81.3% and 56.3%, respectively, in p eritoneal carcinomatosis and a sensitivity of 66.7% and 11.1%, respectively , in HCC-associated ascites, In conclusion, telomerase activity is a more s ensitive marker than cytological examination for differentiating between MR As and NMAs. It may also serve as a useful indicator for detecting early i. p, metastasis in HCC-associated ascites.