The Role of Oxidative Stress Parameters in the Differential Diagnosis of Malignant and Benign Ascites

- OBJECTIVE: Ascites is the pathological fluid accumulation in the perito-neal cavity and there are mainly two reasons for its etiology. These are malignant diseases such as hepatoma or pancreas cancer and be-nign diseases such as liver cirrhosis and heart failure. In this study, we investigated the diag-nostic utility of arylesterase (ARES), paraoxo-nase (PON), stimulated paraoxonase (SPON), catalase (CAT) and myeloperoxidase (MPO) in the differential diagnosis of malignant and be-nign ascites. PATIENTS AND METHODS: This study was conducted between February and September 2016. Patients with acute infection, those tak-ing vitamin supplements and antioxidant medi-cation, smoking, and drinking alcohol were ex-cluded from the study. RESULTS: The study population consisted of 60 patients: 36 had benign (60%) and 24 had ma-lignant (40%) ascites. The mean age of the pa-tients 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 ma-lignant patients compared to benign patients. There was a positive correlation between PON, SPON, and ARES levels, and a negative cor-relation between MPO levels and SPON, ARES, and CAT levels. MPO levels showed superior di-agnostic performance compared to ARES and CAT levels (p<0.05) for predicting malignan-cy but showed no diagnostic superiority com-pared 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 malig-nant and benign ascites.