Value of ascitic fluid cholesterol and serum-ascites albumin gradient in differentiating cirrhotic and malignancy related ascites.

In a perspective study, the ascitic fluid and serum concentration of total cholesterol, total proteins and albumin in a group of 45 patients was studied. Patients with nonmalignant or cirrhotic ascites were compared with patients having malignancy related ascites and it was proved that the ascitic fluid cholesterol and the serum ascites albumin gradient helped to differentiate cirrhotic from malignant ascites. These two parameters showed a remarkable relationship to the presence/absence of malignancy. Non malignant ascites patients had ascitic fluid cholesterol values of 19.41±8.33 mg/dl, as against the malignancy related ascites patients, who showed levels of 95.87±1.24 mg/dl. Similarly, the serum-ascites albumin gradient levels were 2.89±0.65 in non malignant ascites patients, while the malignancy related ascites cases had 0.86±0.50. The discrimination values for cholesterol were taken as 45 mg/dl while that for serum ascites gradient was taken as 1.1. Levels of serum cholesterol, total protein and albumin were not significantly altered.