Background & objective: Cytological examination, despite of its high specificity, has been found to have a low sensitivity in the diagnosis of malignant ascites due to the high percentage of false negative results. So it is indispensable to seek appropriate cancerous markers in ascites. The aim of this study was to determine vascular endothelial growth factor (VEGF), CD44v6 levels and matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) activities in ascites so as to provide scientific basis for clinical diagnosis and treatment of malignant ascites.
Methods: A total of 67 samples were collected, including cirrhotic ascites (36), tuberculosis ascites (8), and malignant ascites (23). VEGF and CD44v6 levels were determined using enzyme-linked immunosorbent assay (ELASA). MMP-2 and MMP-9 activities were determined by gelatin zymography.
Results: VEGF and CD44v6 levels in malignant ascites were 640.74+/-264.81 ng/L and 89.22+/-38.20 microg/L, respectively, which were significantly higher than those in cirrhotic ascites (67.05+/-51.91 ng/L, 44.79+/-18.02 microg/L) and tuberculosis ascites (88.25+/-24.12 ng/L, 50.25+/-12.57 microg/L) (P< 0.01, respectively). The activities of MMP-2 and MMP-9 could not be detected in cirrhotic ascites and tuberculosis ascites but could be detected in 20 and 18 out of 23 malignant ascites respectively.
Conclusion: VEGF, CD44v6 levels increase significantly and MMP-2, MMP-9 activities are obvious in cancerous ascites. The detection of VEGF, CD44v6 levels and MMP-2, MMP-9 activities are useful in differential diagnosis of benign and malignant ascites.