| Background: On the relationship between cholesterol and cancer research abroad have become an increasing attention to the researchers, but the domestic, relevant research is relatively less, especially the research on the relationship between cholesterol content of pleural effusion or ascites and cancer is lacking. In recent years, there are a few literature reports on pleural effusion or ascites cholesterol determination in differential diagnosis of benign and malignant, but its diagnosis value on benign and malignant are still controversial.Objective: To study and analyze the clinical value of cholesterol content and pleural effusion /serum cholesterol ratio in diagnosis of the benign and malignant disease. Methods: A survey was undertaken on the patients with pleural effusion or ascites in the department of cytology, the first affiliated hospital of Anhui Medical University from the December 2006 to may 2008. The cholesterol content of pleural effusion or ascites was detected with cholesterol oxdiase chromometry. At the same time, we measured their serum cholesterol content. All the patients had a clear clinical diagnosis before the end of the survey.Results: A total of 128 cases were enrolled. 60 were pleural effusion; 68 were ascites; Malignant cause was found in 68, and nonmalignant in 60 patients. The experimental results:①.Determination of cholesterol content of pleural effusion or ascites in the malignant was (1.79±0.76) mmol/L and in the benign group was (1.60±0.85)mmol/L. The cholesterol content between two groups was no significant difference (t=1.3352, P=0.1842).②.All patients were divided into four groups by disease characteristics: malignant group, tuberculous group, non-tuberculous inflammatory group, non-inflammatory group. Determination of fluid cholesterol content were compared in the four groups, the difference was statistically significant (F = 25.874, P = 0.000). Compared between each two groups, we found that the cholesterol content of non-inflammatory group was significantly lower than malignant group, tuberculous group, non-tuberculous inflammatory group, the difference has statistical significance. Malignant group was significantly lower than tuberculous group, and difference was statistically significant; there was no statistically significant difference between tuberculous group and non-tuberculous inflammatory group; malignant group and non-tuberculous inflammatory group were no statistically significant differences.③.In malignant effusion group, cholesterol content of cytology positive (1.70±0.76 mmol/L) were than those with negative cytology (1.88±0.76 mmol/L). But the difference was not statistically significant (t=0.9748, P=0.3332).④.Mean cholesterol level in serum of patient with malignant disease was (3.72±1.17) mmol/L, and in nonmalignant group (4.13±1.32) mmol/L. The difference was not statistically significant.⑤.Average pleural fluid/serum cholesterol ratio in nonmalignant group was 0.69±0.27, and in malignant group 0.42±0.19. After analysis, the difference between those mean values was significant (t=6.6008, P=0.0000). At the cut off value of 0.5, the sensitivity was 73.5% and specificity of 76.6%, positive predictive value of 78.1%, negative predictive value was 71.9%, and accuracy was 75.0%.⑥.Furthermore, we found the cholesterol level was significantly correlated with the content of protein in pleural fluid or ascites (r =0.678, P=000). And our results indicate that the determination of cholesterol levels is of great clinical value for distinguishing between exudates and transudates. At the cut off value of 1.12mmol/L, calculated specificity 100.0%, sensitivity was 89.3%. Conclusion: Effusion cholesterol in the diagnosis of benign and malignant disease may not have a greater real value. The pleural effusion /serum cholesterol ratio is probably another means of the differential diagnosis of benign and malignant effusions. In addition, we found the positive correlation between content of cholesterol and protein level in pleural effusion or ascites is obvious. |
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