Evaluation of serum inflammatory cytokines in the diagnosis of ovarian cyst torsion

Abstract

Objective To investigate a possible role for serum inflammatory cytokines [interleukin (IL)-6, 1β and tumor necrosis factor (TNF)-α, interferon-γ] as pre-operative diagnosis index of ovarian cyst torsion. Methods From January 2011 to December 2014, a total of forty cases who were admitted to Shangqiu First People's Hospital with suspected clinical diagnosis of ovarian cyst torsion were prospectively assigned to the study. They were divided into two groups according to surgery examination, study group (n=23, ovarian cyst torsion patients) and control group (n=17, non-ovarian cyst torsion patients). Blood samples were drawn pre-operatively and examined for serum levels of IL-6, -1β and TNF-α, interferon-γ by enzyme-linked immunosorbent assay (ELISA). The levels of serum inflammatory cytokines, receiver operating characteristic (ROC) curve between two groups were analyzed. Meanwhile, the critical value, sensitivity, specificity, positive predictive value, negative predictive value and Youden's index of serum inflammatory cytokines in the diagnosis of ovarian cyst torsion were detected. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Shangqiu First People's Hospital in Henan Province. Informed consent was obtained from each participates. Results Levels of IL-6, -1β and TNF-α, interferon-γ in study group were higher than those in group control[IL-6: (10.92±0.63) pg/mL vs (10.20±0.58) pg/mL; IL-1β: (53.28±15.29) pg/mL vs (34.59±10.27) pg/mL; TNF-α: (8.96±1.50) pg/mL vs (8.02±1.34) pg/mL; interferon-γ: (25.17±6.56) pg/mL vs (16.52±3.71) pg/mL], and all the differences were statistically significant (t=3.69, 4.36, 2.05, 4.88; P=0.000 1, 0.000 1, 0.005 3, 0.034). According to the ROC curve, the area under curve of IL-6, -1β were 0.838 and 0.831, the sensitivity of diagnosing ovarian cyst torsion were 78.3% and 91.3%, the specificity were 82.5% and 82.4%, respectively. Conclusions Elevated serum levels of IL-6 and IL-1β were associated with the occurrence of ovarian cyst torsion. In combination with vague clinical signs of ovarian cyst torsion, serum IL-6 and IL-1β could be the pre-operative diagnostic indices of ovarian cyst torsion. Key words: Cystic ovarian tumors torsion; Serum; Diagnosis; Preoperative period; ROC curve