Celik Handan Ak, Aydin H Hakan, Ozsaran Aydin, Kilincsoy Nermin, Batur Yucel, Ersoz Biltan
Department of Biochemistry, Ege University School of Medicine, Bornova 35100 Izmir, Turkey.
Clin Biochem. 2002 Sep;35(6):477-81. doi: 10.1016/s0009-9120(02)00334-x.
To evaluate differences in ascitic fluid trace element concentrations which might be useful in discrimination between benign and malignant ascites.
The concentrations of copper, zinc, magnesium and iron in ascitic fluid and venous blood in 17 patients were investigated. The relationship between these trace elements and type of disease were examined. Investigations were carried out in a group of 5 males and 5 females aged 54 to 77 yr who had cirrhosis ascites and in a group of 7 females aged 41 to 76 yr with ascites due to gynecologic neoplasms.
The mean ascitic fluid and serum concentrations of copper were significantly higher in neoplastic diseases compared to benign disease states (118,43 vs. 97,50, 91,14 vs. 26.90) (p < 0,05 and p < 0,01 respectively). The zinc levels in ascitic fluid and serum were significantly different between the groups (p < 0,01). Neoplastic patients had significantly higher ascitic fluid magnesium levels than the benign disease group (2,17 vs. 1,55, p < 0,001). The serum levels of iron were significantly lower in the neoplastic diseases group (92, 28 vs. 255, p < 0, 01). In benign diseases the concentration of zinc in ascitic fluid correlated positively with ascitic fluid copper concentrations. The concentrations of zinc and iron in malignant ascites correlate positively with the magnesium concentrations. Statistically significant negative correlations were found between ascites zinc and magnesium and magnesium and copper in cirrhotic patients and magnesium and copper in malignant diseases.
The results showed that zinc, magnesium and iron levels were significantly different between cirrhotic and neoplastic illness. Analysis of serum and ascitic fluid trace element composition may be helpful in identifying and distinguishing the malignant and nonmalignant ascites and provides useful information on processes regulating passage of blood components into the peritoneal cavity.
评估腹水中微量元素浓度的差异，这些差异可能有助于鉴别良性腹水和恶性腹水。
对17例患者的腹水和静脉血中的铜、锌、镁和铁浓度进行了研究。检测了这些微量元素与疾病类型之间的关系。研究对象包括一组年龄在54至77岁之间的5名男性和5名女性肝硬化腹水患者，以及一组年龄在41至76岁之间的7名因妇科肿瘤导致腹水的女性患者。
与良性疾病相比，肿瘤性疾病患者腹水中铜的平均浓度和血清铜浓度显著更高（分别为118.43对97.50、91.14对26.90）（p<0.05和p<0.01）。两组腹水中锌和血清锌水平存在显著差异（p<0.01）。肿瘤患者腹水中镁水平显著高于良性疾病组（2.17对1.55，p<0.001）。肿瘤性疾病组血清铁水平显著较低（92.28对255，p<0.01）。在良性疾病中，腹水中锌浓度与腹水铜浓度呈正相关。恶性腹水中锌和铁的浓度与镁浓度呈正相关。在肝硬化患者中，腹水锌与镁、镁与铜之间以及恶性疾病中镁与铜之间存在统计学显著的负相关。
结果表明，肝硬化和肿瘤性疾病患者的锌、镁和铁水平存在显著差异。分析血清和腹水微量元素组成可能有助于识别和区分恶性和非恶性腹水，并为调节血液成分进入腹腔的过程提供有用信息。
