High-resolution proton nuclear magnetic resonance spectroscopy of ovarian cyst fluid

Most ovarian tumors are cystic structures containing variable amounts of fl uid. Several studies of ovarian cyst fluid focus on one specific metabolite using conventional assay systems. We examined the potential of H-1-nuclear magnetic resonance spectroscopy in evaluation of the overall metabolic com position of cyst fluid from different ovarian tumors. Ovarian cyst fluid sa mples obtained from 40 patients with a primary ovarian tumor (12 malignant and 28 benign) were examined. After deproteinization and pD standardization , we performed H-1-NMR spectroscopy on a 600 MHz instrument. With H-1-NMR s pectroscopy we found detectable concentrations of 36 metabolites with high intersample variation. A number of unassigned resonances as well as unexpec ted metabolites were found. We introduce an overall inventory of the low-mo lecular-weight metabolites in ovarian cyst fluid with corresponding resonan ces. Significant differences in concentration (p < 0.01) were found for sev eral metabolites (including an unknown metabolite) between malignant and be nign ovarian cysts. Furthermore, higher concentrations in malignant- and lo wer in benign fluids were found compared to normal serum values, indicating local cyst wall metabolic processes in case of malignant transformation. W e conclude that H-1-nuclear magnetic resonance spectroscopy can give an ove rview of low-molecular-weight proton-containing metabolities present in ova rian cyst fluid samples. The metabolic composition of cyst fluid differs si gnificantly between benign and malignant ovarian tumors. Furthermore, diffe rences between benign subgroups possibly related to histopathological behav iour can be detected. The presence of N-acetyl aspartic acid and 5-oxoproli ne exclusively in serous cystadenoma samples is remarkable. Future studies will concentrate on these findings and explore the possibilities of extrapo lating information from the in vitro studies to in vivo practice, in which metabolic differences between malignant and benign subtypes can be of great importance in a pre-operative phase. Copyright (C) 2000 John Wiley & Sons, Ltd.