Colli A, Cocciolo M, Riva C, Marcassoli L, Pirola M, Di Gregorio P, Buccino G
Ospedale C. Borella, Giussano, Milano, Italy.
Cancer. 1993 Aug 1;72(3):677-82. doi: 10.1002/1097-0142(19930801)72:3<677::aid-cncr2820720309>3.0.co;2-c.
Ascites in patients with hepatocellular carcinoma (HCC) is a poorly characterized subgroup of malignancy-related ascites. Not only the underlying liver disease, but also the tumor growth and spread contributes to the ascites formation. The authors differentiated ascites in HCC from other types of ascites.
The authors analyzed the ascitic fluid of 185 consecutive patients (89 liver cirrhosis, 33 HCC, 31 peritoneal carcinomatosis, 22 liver metastases, 10 spontaneous bacterial peritonitis).
Each subgroup showed a typical pattern. Compared with the cirrhotic patients, those with HCC showed a higher frequency of positive cytologic findings (4 of 33 versus 0/89, P < 0.004), elevated fibronectin concentration (10/33 versus 8/89, P < 0.004), and elevated polymorphonuclear cell count (10/33 versus 5/89 P < 0.004).
A significant number of patients with ascites and HCC patients showed signs of peritoneal infiltration with positive cytologic findings and increased concentration of fibronectin. Moreover, neutrocytic ascites without signs of superinfection is relatively common (30%).
肝细胞癌（HCC）患者的腹水是恶性肿瘤相关性腹水中特征描述较少的一个亚组。不仅潜在的肝脏疾病，而且肿瘤的生长和扩散都促使腹水形成。作者对HCC患者的腹水与其他类型的腹水进行了区分。
作者分析了185例连续患者的腹水（89例肝硬化、33例HCC、31例腹膜癌、22例肝转移、10例自发性细菌性腹膜炎）。
每个亚组都呈现出一种典型模式。与肝硬化患者相比，HCC患者的细胞学检查阳性结果频率更高（33例中有4例 vs 89例中0例，P < 0.004），纤连蛋白浓度升高（33例中有10例 vs 89例中有8例，P < 0.004），以及多形核细胞计数升高（33例中有10例 vs 89例中有5例，P < 0.004）。
大量腹水患者及HCC患者表现出腹膜浸润的迹象，细胞学检查结果阳性且纤连蛋白浓度升高。此外，无继发感染迹象的中性粒细胞性腹水相对常见（30%）。
