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90th Annual Meeting Abstracts
Angiogenin and Leptin: Potential Targets for the Palliation of Peritoneal Ascites
*Erin K Cooley, MD, *Laura A Lambert, MD, *Barur Rajeshkumar, PhD, *Alice Tran, *Connie Wing-Ching Lee, MS, *Shimul Shah, MD, Giles F Whalen, MD
University of Massachusetts Memorial Medical Center Division of Surgical Oncology, Worcester, MA
Objective: Patients with peritoneal ascites often suffer debilitating symptoms including life-threatening anorexia and cachexia. Symptom management is challenging and often inadequate, resulting in loss of quality of life (QoL). This study investigates the cytokine profiles of malignant and non-malignant ascites for potential targets for palliation.
Design: Prospective, observational study
Setting: Academic medical center
Patients: Thirty adult patients undergoing paracentesis for symptomatic ascites (15 due to non-malignant liver failure; 15 due to gastrointestinal cancer).
Methods: With IRB approval and patient consent, level of expression of 15 cytokines in ascites were determined using the RayBio® protein array. All patients completed FACT-G QoL questionnaires at the time of paracentesis.
Outcome Measures: Relative intensity of cytokine expression was quantified. Significant differences between non-malignant and malignant ascites were determined and correlated with QoL data.
Results: Eight of 15 cytokines were expressed with similar intensity in both non-malignant and malignant ascites (Fig 1). Angiogenin was significantly increased in malignant ascites (*p<0.05). There was greater heterogeneity of cytokine expression in malignant ascites. Cancer patients reported better functional well-being than liver failure patients (42% vs 18%), and liver failure patients reported better emotional well-being (58% vs 41%). Physical and social well-being was similar in both groups.
Conclusions: Targeted, more effective therapy is needed for the palliation of symptomatic ascites. Angiogenin may offer a target for anti-angiogenic therapy in malignant ascites. The appetite suppressant, leptin, may be a potential target for palliation of ascites-related anorexia. 
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