Malignancy of Malignant Ascites: A Comprehensive Review of Interplay between Biochemical Variables, Tumor Microenvironment and Growth Factors.

Malignant ascites, a buildup of fluid in the abdominal cavity, is a serious consequence of many malignancies. This review aims to comprehend the biochemical makeup of malignant ascites, such as pH, cholesterol, protein, etc., which is crucial to developing therapeutics with better treatment outcomes and hence correlate with corresponding prognostic value. The unique tumour microenvironment exhibited by malignant ascites and the crosstalk between inflammatory cells, cytokines and chemokines, interactions between tumour and non-tumour cell types, activation of vital cell signalling pathways within the TME for VEGF-regulated sustained angiogenesis, cancer progression and metastasis is highlighted. This review addresses the need to develop comprehensive assay platforms to identify various biochemical aspects of ascites, to discover the interactions of the tumour microenvironment and to study VEGF-regulated permeability that can expedite early diagnosis and progression of ascites.