Background: Patients with severe forms of cancer are reported to have reduced concentrations of micronutrients in plasma due to the chronic reduction of food intake and an increased metabolism of these components. The purpose of this study was to evaluate if an accumulation of carotenoids, alpha-tocopherol and retinol in malignant ascitic fluid in women with ovarian cancer might contribute to a loss of these components from plasma.
Methods: Blood and ascitic fluid samples obtained from 21 women with ovarian carcinomas and 17 healthy controls were analyzed for retinol, retinol-binding protein (RBP), alpha-tocopherol and carotenoids.
Results: Plasma concentrations of all micronutrients were lower in cancer patients compared to controls. Ascitic fluid concentration of all investigated components was comparable (73-110%) to plasma. While the mean concentration of retinol in malignant ascites represented 73% of that in plasma, the concentration of RBP was less than 10% resulting in an increased mean molar ratio of retinol to RBP from 1.18 to 10.5.
Conclusions: The results suggest that lower plasma concentrations of micronutrients in women suffering from ovarian carcinoma are not only caused by a cachexia-induced decrease of food intake and a higher rate of metabolic utilization, but also by a substantial yet not considered transfer from plasma into ascitic fluid possibly associated with plasma lipoproteins. This raises questions with regard to the protective function of these plasma components in ascitic fluid, the consequences of paracentesis on an additional supplementation and finally the possibility to use one or a combination of these components as an additional marker to discriminate between benign and malignant ascites.
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