Evaluation of Telomerase Activity in AsciticFluid of Benign &MalignantOrigins

Abstract

Patients presenting with ascites of unidentified etiology are not uncommon. The differential diagnosis includes benign (inflammatory, infections, autoimmune..etc) and malignant causes. The most frequent cause of ascites in clinical practice is liver cirrhosis. A condition maybe associated with hepatocellular carcinoma in considerable number of patients. Alpha fetoprotein is a tumor marker used in diagnosis of HCC with good specificity however, its sensitivity is not satisfactory for its use as a single test for screening protocols. In this study we examined ascetic fluid telomerase in patients with different causes of ascites to find out whether it can be used to diagnose ascites associated with malignancy. Our patients were divided into three groups; group I included patients with ascites associated with liver cirrhosis. Group II included patients with HCC on top of liver cirrhosis. Group III included patients with ascites associated with other malignancies (cancer ovary, colon and gastric cancer). We found that telomerase in ascetic fluid was detected significantly more frequent and with higher concentration in groups with malignancy (II & III) compared to group I without malignancy. In addition, telomerase detection in patients with malignancy was significantly more frequent than presence of positive malignant cells (cytology) in these patients.