Based on the facts that expression of insulin-like growth factors(IGFs), their receptors, and insulin-like growth factor binding proteins(IGFBPs) have been found in many different types of malignancies including human ovarian cancer and their potent mitogenic effects in vitro, a role for IGFs mediated autocrine loop in oncogenesis and growth regulation of human malignancies was suggested. Since ascites support the biological environment for advanced ovarian cancer, it seemed to be resonable to measure the level of growth factors or cytokines in ascites for understanding precise mechanism of those factors in tumor biology. To investigate their roles and to evaluate prognostic significance in ovarian cancer, the IGFs/IGFBPs system were studied in the ascites, not in sera or cystic fluids, from 22 patients with ovarian cancer, who underwent surgical staging and subsequent cis-platinum based systemic chemotherapyery at the Department of Obstetrics and Gnecology, Hanyang University Hospital from Jan. 1989 through Dec. 1994. Ascites from 7 patients with benign disease were used as the control. IGF-I, II, IGFBP-1, and 3 were measured by immunoradiometric assay. The IGF-I level was significantly higher in ascites with ovarian cancer compared with those of benign disease(63.3-/+11.1 vs 17.9-/+6.2ng/ml, p=0.0098), but the level of IGF-II was not significantly different(70.5-/+13.9 vs 70.8-/+31.5 ng/ml, p=0.2827). IGFBP-1 levels were tend to be lower in ascites of patients with ovarian cancer than that of control(25.2-/+9.5 vs 58.6-/+28.2ng/ml, p=0.0637). However, IGFBP-3 levels had no statistically significant difference between two groups(779.7-/+110.6 vs 674.7-/+175.1ng/ml, p=0.8328). Although growth hormone levels were significantly higher in ascites with metastatic ovarian cancer than those of primary epithelial ovarian cancer, the levels of IGF-I, II, IGFBP-1 and 3 in ascites were not significantly different between two groups. IGF-I levels were correlated with the levels of IGFBP-3 in ascites with ovarian cancer(Y=8.83X-2.0, r=0.745, p=0.0000). High level of IGF-I in ascites of patients with ovarian cancer in this study was suggested that IGF-I had an important role on growth regulation of ovarian cancer. As majority of ascites were obtained from advanced and poorly differentiated ovarian cancer patients, IGF-I in ascites seemed to be related with intraperitoneal metastasis. Further large number of study including data from sera or cystic fluid will be needed to elucidate the role of the IGFs and IGFBPs in ascites of patients with ovarian cancer.