Diagnostic Utility of Peritoneal and Ovarian Fluid LDH and Cholesterol in Cystic Ovarian Tumours

Background: Ovarian cancer is the third most common cancer in Indian women. Biochemical analysis of ovarian and peritoneal fluid, especially lactate dehydrogenase (LDH) and cholesterol level is shown to be elevated in cases of malignancy. Peritoneal fluid LDH levels were also found to be of prognostic significance. To assess the diagnostic utility of LDH and cholesterol levels of ovarian cyst fluid and peritoneal fluid in cystic ovarian neoplasms by correlating with histopathological examination. Material and Methods: Prospective cohort study carried out in a tertiary care hospital. Ovarian cyst fluid and/or peritoneal fluid in resected ovarian neoplasms were processed on automated biochemistry analyzers.Results: Seventy-nine ovarian neoplasms with their corresponding ovarian cyst fluid and/or peritoneal fluid were studied. The accuracy rate for diagnosis of malignant tumors by ovarian fluid LDH and cholesterol levels was found to be 100% and 90.14% respectively, while that of peritoneal fluid LDH and cholesterol levels was 88.88% and 80.55% respectively.Conclusion: Biochemical analysis (LDH and cholesterol) of peritoneal fluid can be used in pre-operative and post-operative management of ovarian malignancy. Ovarian fluid LDH was the most sensitive and specific parameter followed by peritoneal fluid LDH for differentiating ovarian malignancy from benign ovarian tumors.