PATHOPHYSIOLOGY OF ELEVATED ASCITES-FLUID CHOLESTEROL IN MALIGNANT ASCITES - INCREASED ASCITES TO SERUM RELATION OF PROTEINS AND LIPOPROTEINS IN PATIENTS WITH PERITONEAL CARCINOMATOSIS AS COMPARED TO PATIENTS WITH CIRRHOSIS OF THE LIVER
PATHOPHYSIOLOGY OF ELEVATED ASCITES-FLUID CHOLESTEROL IN MALIGNANT ASCITES - INCREASED ASCITES TO SERUM RELATION OF PROTEINS AND LIPOPROTEINS IN PATIENTS WITH PERITONEAL CARCINOMATOSIS AS COMPARED TO PATIENTS WITH CIRRHOSIS OF THE LIVER
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DOI：
10.1016/0168-8278(92)90165-l
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发表时间：
1992-03-01
影响因子：
25.7
通讯作者：
GERBES, AL
中科院分区：
文献类型：
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作者：
JUNGST, D;XIE, YN;GERBES, AL
与肝硬化患者相比，在腹膜癌转移患者中观察到腹水胆固醇显著升高，这在鉴别诊断中很有用。 这一发现可能是由于血浆脂蛋白进入腹膜腔的运动增强所致。 为了验证这一假设，我们测定了17例肝硬化患者和16例腹膜癌转移患者血清和腹水中总胆固醇、高密度脂蛋白（HDL）-胆固醇和低密度脂蛋白（LDL）-胆固醇、载脂蛋白-A1（apo-A1）和载脂蛋白-B（apo-B）的空腹浓度。 蛋白质从血浆到腹水的移动由6种不同大小的蛋白质的腹水/血清浓度比计算，其分子量范围为54 kDa至971 kDa。 腹水中总胆固醇（92.6 vs. 21.0）、HDL-胆固醇（15.6 vs. 1.8）、LDL-胆固醇（63.4 vs. 16.1）、apo-A1（50.2 vs. 13.6）和apo-B（41.2 vs. 12.9）的平均值（mg/dl）在腹膜癌转移中显著高于肝硬化。 这些差异只能部分解释为腹膜癌病中这些参数的血清浓度较高，但主要是由于腹膜癌病中血浆蛋白和脂蛋白进入腹水（平均腹水/血清（A/S）比：0.30-0.77）的选择性低于肝硬化（平均腹水/血清比：0.11-0.21）。 在两组中，血清和腹水中约85%的总胆固醇由HDL-和LDL-胆固醇组成。 这些发现支持了这样的假设，即腹水胆固醇在腹膜癌病相比，肝硬化的升高主要是由血浆HDL和LDL进入腹膜腔的运动增加。
The existence of marked elevations of ascitic fluid cholesterol has been observed in patients with peritoneal carcinomatosis compared to patients with cirrhosis and has been found useful in differential diagnosis. This finding could be caused by an enhanced movement of plasma lipoproteins into the peritoneal cavity. To test this hypothesis we determined the fasting concentrations of total, high density lipoprotein (HDL)- and low density lipoprotein (LDL)-cholesterol, apolipoprotein-A1 (apo-A1) and apolipoprotein-B (apo-B) in serum and ascites of 17 patients with cirrhosis and 16 patients with peritoneal carcinomatosis. The movement of proteins from plasma to ascites was calculated from the ascites/serum concentration ratios of six different sized proteins with a molecular mass ranging from 54 kDa to 971 kDa. Mean values (mg/dl) for total cholesterol (92.6 vs. 21.0), HDL-cholesterol (15.6 vs. 1.8), LDL-cholesterol (63.4 vs. 16.1), apo-A1 (50.2 vs. 13.6) and apo-B (41.2 vs. 12.9) in ascites were significantly higher in peritoneal carcinomatosis than in cirrhosis. These differences could only partially be explained by the higher serum concentrations of these parameters in peritoneal carcinomatosis, but were mainly due to a lower selectivity for the movement of plasma proteins and lipoproteins into ascites (mean ascites/serum (A/S) ratio: 0.30-0.77) in peritoneal carcinomatosis as compared to cirrhosis (mean ascites/serum ratio: 0.11-0.21). In both groups about 85% of the total cholesterol in serum and ascites consisted of HDL- and LDL-cholesterol. These findings support the hypothesis that elevations in ascitic cholesterol in peritoneal carcinomatosis compared to cirrhosis are mainly caused by the increased movement of plasma HDL and LDL into the peritoneal cavity.