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PubMed1999

Chemical analysis of adnexal cyst fluid.

OBJECTIVE: The purpose of the study was to determine if adnexal cyst fluid glucose, protein, and lactate dehydrogenase (LDH) levels can discriminate between cancerous and noncancerous adnexal masses. METHODS: Intracystic fluid was aspirated from adnexal masses immediately after operative excision. Patient age and menopausal status, mass size, and cyst fluid specific gravity were recorded. Cyst fluid and intraoperative serum glucose, protein, and LDH levels were measured. Masses were grouped by histopathologic diagnosis. Cyst fluid chemical levels and cyst fluid/serum ratios were compared among and between the groups. RESULTS: Fifty-eight adnexal masses were analyzed: 15 nonneoplastic (group 1), 23 benign neoplastic (group 2), and 20 malignant (group 3). There were no significant differences among the groups with regard to patient age, menopausal status, or cyst fluid specific gravity. Cyst size (cm2) was significantly different among the three groups (P < 0.01), with the largest mean size found in the cancer group. No significant differences in cyst chemistries or cyst fluid/serum ratios were found between groups 1 and 2. Comparing groups 1 and 3, all values were significantly different (P < 0.05), with the greatest level of significance attained by comparison of cyst fluid LDH levels (P < 0.001). Groups 2 and 3 statistically differed in cyst fluid levels and cyst fluid/serum ratios of both protein and LDH, with the highest levels of significance achieved by comparisons of cyst fluid levels and ratios of LDH (P = 0.001 and P < 0.001, respectively). The cyst fluid LDH level was found to be the best single chemistry for distinguishing noncancerous (groups 1 and 2) from cancerous (group 3) adnexal masses. A cyst fluid LDH level of >/=451 U/L imparted a 90% sensitivity and 71% specificity for detecting malignancy. CONCLUSIONS: Evaluation of adnexal cyst fluid LDH may help to distinguish benign from malignant adnexal masses. More cases are needed to adequately assess the predictive value and clinical utility of this approach.

Adnexal Diseases↗
PubMed1988

Ciprofloxacin activity in cyst fluid from polycystic kidneys.

Renal cyst infection in patients with polycystic kidney disease (PKD) is often unresponsive to standard antimicrobial therapy, in part because of the failure of most antibiotics to adequately penetrate cyst fluid. Ciprofloxacin, a new quinolone antibiotic, possesses in vitro activity against most pathogens likely to be encountered in renal cyst infection. To study the potential usefulness of ciprofloxacin for the treatment of cyst infection, fluid from 70 cysts was obtained from seven patients with polycystic kidney disease who were receiving the drug. Cysts were categorized as nongradient or gradient by the sodium concentration in the fluid. The ciprofloxacin concentration within cysts was measured, and the cyst fluid bactericidal activity against likely cyst fluid pathogens was determined. The mean (+/- standard error) ciprofloxacin concentration was 12.7 +/- 2.9 micrograms/ml. Preferential accumulation of ciprofloxacin occurred in gradient cysts; these levels exceeded levels in serum by more than fourfold. Cyst fluid bactericidal activity titers were uniformly high against Escherichia coli and Proteus mirabilis, while less activity was observed against Streptococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis.

Adult↗
PubMed2000

High-resolution proton nuclear magnetic resonance spectroscopy of ovarian cyst fluid.

Most ovarian tumors are cystic structures containing variable amounts of fluid. Several studies of ovarian cyst fluid focus on one specific metabolite using conventional assay systems. We examined the potential of (1)H-nuclear magnetic resonance spectroscopy in evaluation of the overall metabolic composition of cyst fluid from different ovarian tumors. Ovarian cyst fluid samples obtained from 40 patients with a primary ovarian tumor (12 malignant and 28 benign) were examined. After deproteinization and pD standardization, we performed (1)H-NMR spectroscopy on a 600 MHz instrument. With (1)H-NMR spectroscopy we found detectable concentrations of 36 metabolites with high intersample variation. A number of unassigned resonances as well as unexpected metabolites were found. We introduce an overall inventory of the low-molecular-weight metabolites in ovarian cyst fluid with corresponding resonances. Significant differences in concentration (p < 0.01) were found for several metabolites (including an unknown metabolite) between malignant and benign ovarian cysts. Furthermore, higher concentrations in malignant- and lower in benign fluids were found compared to normal serum values, indicating local cyst wall metabolic processes in case of malignant transformation. We conclude that (1)H-nuclear magnetic resonance spectroscopy can give an overview of low-molecular-weight proton-containing metabolities present in ovarian cyst fluid samples. The metabolic composition of cyst fluid differs significantly between benign and malignant ovarian tumors. Furthermore, differences between benign subgroups possibly related to histopathological behaviour can be detected. The presence of N-acetyl aspartic acid and 5-oxoproline exclusively in serous cystadenoma samples is remarkable. Future studies will concentrate on these findings and explore the possibilities of extrapolating information from the in vitro studies to in vivo practice, in which metabolic differences between malignant and benign subtypes can be of great importance in a pre-operative phase.

Adult↗
PubMed1995

Concentrations of soluble vascular cell adhesion molecule-1 and E-selectin in breast cyst fluid and their relation with cyst type.

Gross cystic breast disease may be associated with a higher risk of breast cancer. There are two groups of mammary cysts: those lined by apocrine epithelium (intracystic sodium to potassium (Na:K) ratio < 3) and those lined by flattened epithelium (intracystic Na:K ratio > 3). Cell adhesion molecules may be involved in various stages of tumour metastasis. Intracystic levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble E-selectin (sE-selectin) were measured. Significantly greater concentrations of sVCAM-1 and sE-selectin occurred in the high-electrolyte ratio group than in the low (P < 0.001). A positive correlation was found between sVCAM-1 and sE-selectin (rs = 0.827, P < 0.001) which may be a chance observation or suggest a common mechanism of entry into mammary cysts. The significance of these soluble cell adhesion molecules in breast cyst fluid requires elucidation.

Cell Adhesion Molecules↗
PubMed1981

Cyst fluid antibiotic concentrations in polycystic kidney disease: differences between proximal and distal cysts.

The concentrations of several antibiotics were measured in the cyst fluid of six adult patients with polycystic kidney disease. Seventy-nine cysts were aspirated at surgery or autopsy. Sixty-one cysts could be categorized as arising from the proximal nephron and 16 from the distal nephron by cyst fluid to serum sodium ratios. Serum, urine, and cyst fluid were simultaneously analyzed for sodium, creatinine, and various antibiotics. Gentamicin, tobramycin, cephapirin, and ticarcillin were either undetectable or present in low concentrations in renal cysts. Cyst fluid antibiotic concentrations did not correlate with cyst volume or creatinine clearance. Cysts of proximal nephron origin had higher antibiotic concentrations than distal cysts. In one patient with normal renal function, inulin was undetectable in renal cysts after a continuous 36-hour i.v. infusion. Para-aminohippurate, however, was detected in the renal cysts of this patient. These data help explain the poor clinical response of infected renal cysts to antibiotic therapy. They also suggest that antibiotics and other solutes may enter cyst fluid across tubular cells in addition to entry by glomerular filtration.

Anti-Bacterial Agents↗
PubMed1992

CA 125 concentrations in ovarian 'chocolate' cyst fluid can differentiate an endometriotic cyst from a cystic corpus luteum.

In a prospective study, the concentrations of CA 125, 17 beta-oestradiol and progesterone were assayed in 52 consecutive ovarian cysts, laparoscopically suspected to be endometriomas. Cysts with dark brown 'chocolate' fluid (n = 42) were excised by CO2-laser endoscopy. Cysts with clear fluid were diagnosed by pathology as follicular cysts (n = 5) or pseudoperitoneal cysts (n = 5). Fluids (n = 53) aspirated during echo-guided puncture for in-vitro fertilization (IVF) were assayed simultaneously. Of the 42 women undergoing a cystectomy, the clinical diagnosis of an endometrioma was confirmed by pathology in only 68%, the other cases being corpora lutea (27%) or follicular cysts (5%). Cyst fluids from corpora lutea had lower CA 125 concentrations (< 1000 IU/ml) together with high 17 beta-oestradiol concentrations (> 2000 pg/ml) and/or high progesterone concentrations (> 100 ng/ml). Endometriotic cysts had either very high CA 125 concentrations (> 10,000 IU/ml) as occurred in 78% or lower CA 125 concentrations (< 1000 IU/ml) together with low 17 beta-oestradiol and/or progesterone concentrations. 'Chocolate' fluid-containing cysts aspirated during IVF had similar concentration profiles of CA 125, 17 beta-oestradiol and progesterone and the diagnoses derived from these concentrations were not contradicted in 19/27 women undergoing a laparoscopy within 4 months. In eight women, however, with high CA 125 concentrations in their cyst fluid, no endometriotic cysts were found at laparoscopy. Only 68% of cysts containing 'chocolate' material were endometriotic cysts and CA 125 could be useful in making this diagnosis. This method is recommended when dark brown fluid is aspirated in IVF.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1991

Accumulation of active androgens in breast cyst fluids.

80 breast cyst fluids (BCF) from 57 patients were divided by K+/Na+ ratio: 56 with ratio over 1 (type I) and 24 with ratio less than 1 (type II). Significantly higher amounts of testosterone, dihydrotestosterone and dehydroepiandrosterone sulphate (DHAS) were found in type I than in type II cysts. A positive relation was found between testosterone and dihydrotestosterone in both types. DHAS was significantly correlated with testosterone and dihydrotestosterone in type I casts only. In 52 patients, blood was sampled after cyst evacuation. Testosterone was significantly higher in blood than in BCF while dihydrotestosterone and androstenedione were significantly higher in BCF. No relation was observed between circulating levels of androgens and their intracystic concentrations. Women bearing type I cysts may be at increased risk of developing cancer. These findings support the hypothesis that androgens play a role in the hormonal aetiology of breast cancer.

Adult↗
PubMed1996

Angiotensin-converting enzyme and enkephalinase in human breast cyst fluid.

Palpable breast cysts with an apocrine epithelial lining (type 1) are reported to be associated with a higher risk of developing breast cancer. The composition of breast cyst fluid (BCF) might include those factors involved in this increased risk. In this study peptidase activities that were active against the substrate [125I]metenkephalin-Arg-Phe were detected in BCF. The products were identified by reversed phase high-performance liquid chromatography (HPLC) as [125I]Tyr-Gly-Gly and [125I]Met-enkephalin. This proteolysis was not inhibited by PCMB, pepstatin A, leupeptin or aprotinin but was by EDTA, showing that the activity was due to metalloproteases. The production of [125I]Try-Gly-Gly was inhibited by phosphoramidon and thiorphan, whereas that of [125I]met-enkephalin was inhibited by captopril and Bothrops jararaca peptide, indicating that these activities are enkephalinase and angiotensin-converting enzyme (ACE) respectively. A fluorometric assay for ACE demonstrated that ACE levels are significantly higher in type 2 BCF than in type 1 BCF (30.8 vs 6.1 nmol hr-1 10 microliters-1, P < 0.001). As the increased risk of cancer is linked to type 1 cysts it is possible that higher levels of peptidase in type 2 BCF reflect a protective environment in the breast in which mitogenic peptide growth factors are neutralised by proteolysis.

Amino Acid Sequence↗
PubMed1992

Preliminary characterization of anticomplementary components of hydatid cyst fluid.

Sheep hydatid cyst fluid (SHCF) was fractionated on Sephacryl HR S-200 and the anticomplementary activity (alpha-C activity) determined in the fractions obtained; 67% of total alpha-C activity of SHCF was recovered in the void volume fraction (SHCF-I) which contained 61% of SHCF carbohydrates. The bulk of the activity of SHCF-I was eluted by FPLC chromatofocusing on Mono P HR at pH 5.9. After heating at 100 degrees C for 15 min, SHCF and SHCF-I conserved 74 and 54%, respectively of their alpha-C activity. In addition, 37 and 11% of SHCF and SHCF-I alpha-C activity, respectively bound to Protein A. Components not bound to Protein A (SHCFPA and SHCF-IPA) were fractionated on Con A-Sepharose; 71 and 65%, respectively of their total alpha-C activity was retained by this lectin indicating the presence of alpha-D mannoside and alpha-D glucoside residues in the active molecules. Our results suggest that SHCF could contain two classes of alpha-C components: immune complexes and thermoresistant molecules with high carbohydrate content.

Animals↗
PubMed1994

Epidermal growth factor and endothelin in cyst fluid from autosomal dominant polycystic kidney disease cases: possible evidence of heterogeneity in cystogenesis.

We determined the concentrations of immunoreactive epidermal growth factor (EGF), endothelin (ET), and cyclic adenosine monophosphate (cAMP) in cyst fluid from 10 nondialyzed patients with autosomal dominant polycystic kidney disease (ADPKD). The concentrations of ET and cAMP in low-sodium cyst fluid (cyst sodium concentration < 100 mEq/L) were significantly increased compared with those in high-sodium cyst fluid (cyst sodium concentration > or = 100 mEq/L), but the concentration of EGF did not differ between the two. There was no relationship between cyst fluid volume and EGF, ET, cAMP values in ADPKD cases. Significant variations of cyst fluid concentrations of EGF, ET, and cAMP were observed among the patients. However, the differences of these variables between the right and left kidney of the individual subjects were unremarkable. Serum levels of creatinine and urea nitrogen showed significant negative correlations with EGF, but not with ET and cAMP. The present data demonstrate the differences in cytokine activity among cysts in ADPKD cases, suggesting the heterogeneity of cystogenesis along the tubular segments in this particular disease.

Adult↗
PubMed1990

Identification of a unique biological tumor marker in human breast cyst fluid and breast cancer tissue.

Breast cyst fluid from 35 women was stratified into risk groups based on personal and family history of breast cancer. Mitogenic activity in breast cyst fluid of women at highest risk to develop breast cancer was significantly higher than the activity in the lowest-risk group. There was a direct dose-dependent relationship between mitogenic activity and increased risk of developing breast cancer. Size-exclusion chromatography showed that breast cyst fluid from women at highest risk contained two peaks of growth factor activity: less than 6 kilodaltons (kd), identified as human EGF (epidermal growth factor), and 6 to 18 kd. Moderate-risk group samples demonstrated only the single less than 6 kd peak, whereas the lowest-risk group had insignificant growth-promoting activity. Breast cancer tissue analyzed in a similar manner revealed a predominant 6- to 14-kd peak of mitogenic activity demonstrating the same acid- and heat-stability found in breast cyst fluid.

Biomarkers, Tumor↗
PubMed1992

Comparative immunoelectrophoretic analysis of Echinococcus granulosus, Taenia hydatigena and Taenia pisiformis cyst fluid antigens by hyperimmune rabbit sera.

Cyst fluid antigens of Echinococcus granulosus, Taenia hydatigena and T pisiformis were examined by electrophoresis using homologous and heterologous hyperimmune rabbit sera to these antigens. While arc 5 forming antibodies were identified in sera from rabbits immunised with E granulosus and T hydatigena cyst fluids, antibodies responsible for forming precipitating antigen B band were detected in rabbit antisera to E granulosus, T hydatigena and T pisiformis antigens. T hydatigena cyst fluid appears to contain antigen similar to E granulosus antigen 5 and probably antigen B while T pisiformis cyst fluid has mainly an antigen close to hydatid antigen B.

Animals↗
PubMed1975

A study of biological chemistry on the nature of jaw cysts. On the maintainance of homoeostasis in jaw cyst fluid.

Jaw cyst lining cells have an active transporting mechanism for Na+ ion and K+ion, a secreting mechanism and a selecting mechanism, and they allow permeation of electrolytes, lipids and protein into cysts. The components within the cysts have a controlling metabolism, and keep the system stable. Tumour wall cells of cystic ameloblastoma have only a passive transporting mechanism for various substances. Their nature differs from that of jaw cyst lining cells.

Ameloblastoma↗
PubMedDate not supplied

Androblastoma: pre-, per- and post-operative steroid hormone and binding protein concentrations in peripheral plasma, cyst fluid and tumor vein.

A case-report of arrhenoblastoma is presented where the endocrine profile has been determined before, during and after removal of the tumor. Sex steroids, cortisol, corticosteroid binding globulin (CBG) and sex steroid binding protein (SBP) were measured in fluid from 2 cysts, tumor vein and peripheral plasma. Hormones were measures by specific RIAs after stepwise chromatography on celite support according to a new elution pattern allowing the resolution of 8 sex steroid in a single chromatographic system. Excessive amounts of androgen, the most prominent being testosterone, and 17-OH-progesterone, but low levels of estrogens and progesterone were found in preoperative plasma. Due to an androgen-directed rise of CBG, large amounts of plasma cortisol were detected. However, preoperative SBP capacity was found to be reduced. The steroid profile of cyst fluids was found to be similar to that of peripheral plasma. Neoplastic cells were found capable of producing an androgen binding protein. These results correlated well with Sertoli-Leydig cell tumors histology, i.e. a testis-like endocrine structure. From the endocrine profile, the steroid biosynthetic pathways are discussed with respect to the possibility that biosynthesis, once the 17-OH-pregnenolone structure was reached, was active along both the delta 5 and delta 4-steroid pathways. The steroid levels in tumor vein and their corresponding gradients to the periphery are discussed with respect to: i) the possibility of metabolic and biosynthetic capacities of cancer cells bearing an undifferentiated steroidogenic appearance, ii) the possibility for tumor steroid secretion by others means than by venous blood and iii) the possibility that both point i) and ii) could be the cause of inconsistent diagnosis significant of endocrine profile as observed in some patients.

Adolescent↗
PubMed1990

Protein antigens in the cyst fluid of Taenia saginata cysticerci.

Taenia saginata cyst fluid proteins from 4, 8, 12 and 16-week-old cysticerci were analysed by a combination of direct 125I radio-isotope labelling, immunoprecipitation using a panel of sera from infected cattle infected with T. saginata and SDS-PAGE. Protein antigens of 12, 14, 16, 20 and 26 kDa were identified in all of the cyst fluids examined. These were immunogenic and were precipitated by serum taken from cattle from 8 weeks after infection onwards and were therefore considered to be of diagnostic potential. A 185 kDa protein antigen found only in the cyst fluid of 4-week-old cysticerci and a 43 kDa protein antigen first detected in cyst fluid from 8-week-old cysticerci were also identified but were considered to be of more limited diagnostic potential due to their restricted presence. An apparently non-immunogenic 67 kDa protein, found in all the cyst fluids examined, may have been host serum albumin.

Animals↗
PubMed1997

[Biochemical and endocrinological analysis of breast cyst fluid].

The gross cystic disease (breast cyst < 3 mm in diameter) is common benign disease of the breast. The relations GCD with breast cancer remain the fundamental problem. Although the cysts itself only exceptionaly degenerates into cancer, the presents of macrocystic disease multiplies by 3 to 4 the risk of cancer. A lot of interesting examinations were performed on cyst fluids aspirated from patients to identify women with benign breast disease and particular risk for breast cancer. There are two groups of breast cysts: these lined by apocrine epithelium and those lined by flattened epithelium. It is generally accepted that measurement of intracystic [Na+]/[K+] is a simple way of differentiating between these two groups of cysts. Higher intracystic concentrations of same substances may provide an explanation for the higher risk of breast cancer, which has been observed in low electrolyte group. Breast cyst fluid samples were analyzed for a lot of hormones, proteins, specific growth factors, adhesion molecules, bile acids, tumor markers and their levels were compared with breast cancer risk. At the present time, the biochemical measurements in cyst fluids aren't popular to identify women likely to develop breast cancer. We should use other diagnostic methods to examine these patients.

Adult↗
PubMed1985

Platelet-associated proteins in human breast cyst fluids.

Thrombospondin, beta-thromboglobulin and platelet factor 4 were measured by radioimmunoassay in fluids from 50 human breast cysts. beta-Thromboglobulin concentrations were less than 4-330 ng/ml (median 13.5 ng/ml), while normal plasma contained 14-80 ng/ml. Cyst fluids contained 8-225 ng/ml platelet factor 4 with a median of 25 ng/ml (range in plasma 6.5-29 ng/ml). Thrombospondin levels in cyst fluids were 65-55 000 ng/ml (median 2 500 ng/ml) and 92% contained concentrations above the plasma range (58-215 ng/ml). When cyst fluids were classified by their electrolyte composition, group II cysts had similar levels of platelet factor 4 but significantly higher levels of beta-thromboglobulin and thrombospondin than group I. From the remarkably high concentrations of thrombospondin within cyst fluids and the differences between cyst types, it seems that either the protein is synthesised locally or selectively accumulated. Increased platelet activation is unlikely to be the source of the high thrombospondin levels in group II cysts.

Beta-Globulins↗
PubMed1984

pH of human breast cyst fluids.

The pH of 106 human breast cyst fluids has been measured immediately following aspiration. Values ranged from pH 6.3 to 7.8. They correlated with the ratio of Na+ to K+ in cyst fluid and differed significantly in the two populations of fluids which can be defined on electrolyte composition. Storage of cyst fluid for one month at -20 degrees C resulted in an increase in pH by a mean of 0.9 of a unit. pH provides a simple method for typing cyst fluids and this may be of clinical importance as there is evidence that there are differences in the natural history and association with breast cancer in the two populations of breast cysts.

Apocrine Glands↗