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.