Sialic Acid: A Tumour Marker for Malignant Ascites
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Background: Accumulation of ascitic fluid is one of the most common diagnostic problems facing physicians. Identification of related biological tumour markers associated with neoplasia is the goal of many investigators. Sialic acid (SA) is recently claimed to be valuable in the differential diagnosis of neoplasia. A im: To evaluate the diagnostic accuracy of sialic acid in serum as well as ascitic fluid in cases of malignancy associated ascites compared to cirrhosis associated ascites. Methods: This study included 15 cases with liver cirrhosis, 15 cases with malignant ascites and 10 normal controls, Sialic acid was determined in serum and ascitic fluid using a thiobarbituric acid assay. Results: Mean serum sialic acid in controls: 20.9± 5.3 mg/di, cirrhosis: 148.9 ± 198.5 mg/di and malignant ascites: 513 ± 277.8 mg/c11. Significant difference were found between controls and cirrhosis and malignant ascites (P<0.01, Pc 0.01) and between cirrhosis and malignancy (P <0.001). Mean ascitic fluid sialic acid for cirrhosis was 212.4 ± 157.3 mg/di and malignant ascites: 418.5 ± 205.5 with significant difference (P < 0.01). Sensitivity and specificity for detection of malignancy were 80% and 80% for serum SA (cut off at 120 mg/di), and for ascetic fluid SA were 86.7% and 80% (cut off at 225 mg/d1). Conclusion: Sialic acid quantification in serum and ascitic fluid seems to be a reliable marker for the presence of malignancy, especially when occurring on top of cirrhosis.