The role of oxidative stress parameters in the differential diagnosis of malignant and benign ascites

A.A. Surel, M.K. Çolakoğlu, E.B. Bostancı, O. Erol

Department of General Surgery, Ankara City Hospital Training and Research Hospital, Ankara, Turkey. dr.aasurelash@gmail.com

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• Gastroenterology

OBJECTIVE: Ascites is the pathological fluid accumulation in the peritoneal cavity and there are mainly two reasons for its etiology. These are malignant diseases such as hepatoma or pancreas cancer and benign diseases such as liver cirrhosis and heart failure. In this study, we investigated the diagnostic utility of arylesterase (ARES), paraoxonase (PON), stimulated paraoxonase (SPON), catalase (CAT) and myeloperoxidase (MPO) in the differential diagnosis of malignant and benign ascites.

PATIENTS AND METHODS: This study was conducted between February and September 2016. Patients with acute infection, those taking vitamin supplements and antioxidant medication, smoking, and drinking alcohol were excluded from the study.

RESULTS: The study population consisted of 60 patients: 36 had benign (60%) and 24 had malignant (40%) ascites. The mean age of the patients was 63.3 years. MPO levels (14.2 vs. 4.2; p=0.028) were found to be higher and PON (2.6 vs. 4.5; p<0.001), SPON (10.7 vs. 23.9; p<0.001), ARES (615.7 vs. 823.5, p<0.001) and CAT (13.3 vs. 36.8; p=0.044) were found to be lower in malignant patients compared to benign patients. There was a positive correlation between PON, SPON, and ARES levels, and a negative correlation between MPO levels and SPON, ARES, and CAT levels. MPO levels showed superior diagnostic performance compared to ARES and CAT levels (p<0.05) for predicting malignancy but showed no diagnostic superiority compared to PON and SPON levels (p>0.05).

CONCLUSIONS: PON, SPON, ARES, CAT, and MPO can be used with high sensitivity and specificity in the differential diagnosis of malignant and benign ascites

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