Papel das interleucinas nos endometriomas e neoplasias ovarianas

Abstract

Introduction: studies have shown a relationship between endometriosis and ovarian cancer. Objectives: were to evaluate and compare the dosages of cytokines IL-2, IL-5, IL-6, IL-8, IL-10 and TNF-α in serum, intracystic fluid and peritoneal fluid of patients diagnosed with ovarian endometrioma, malignant and benign ovarian neoplasms, and non-neoplastic ovarian tumors; to verify if there is a correlation between the values of these cytokines between the group of patients with ovarian endometrioma and patients with a confirmed diagnosis of ovarian malignancy, in the different environments studied (serum, intracystic fluid and peritoneal fluid); and to determine the best cutoff point for serum interleukins that can be used to differentiate patients with ovarian malignancy and endometrioma. Materials and methods: this study involved 153 patients, 20 with non-neoplastic ovarian lesions, 82 with benign neoplasia, 30 with malignant neoplasia, and 21 with endometrioma. The concentrations of cytokines IL-2, IL-5, IL-6, IL-8, IL-10 and TNF-α were quantified by Enzyme-Linked Immunosorbent Assay (ELISA). Cytokine concentrations were analyzed by Kruskal-Wallis test with the Dunn posttest. For cytokines that were statistically significant, a Receiver Operating Feature (ROC) curve was used to obtain the Area Under the Curve (AUC) and to determine the best cutoff values that could be used in the diagnosis of ovarian malignancy. Correlations of cytokine concentrations were performed by the Spearman test. Statistical significance was set at p<0.05. Results: IL-6 serum and intracystic fluid concentrations were higher in patients with malignant neoplasia compared to patients with benign neoplasia, as well as in peritoneal fluid, where IL-6 concentrations were also higher in patients with malignant neoplasia in compared to patients with non-neoplastic ovarian tumors. Serum IL-8 and IL-10 concentrations were higher in malignant neoplasms than in endometriomas. There was a positive correlation of serum IL-5 levels, and a positive correlation of IL-10 in the peritoneal fluid between groups of endometriomas and ovarian malignancies. When evaluating the AUC of serum cytokine levels comparing patients with malignant neoplasia and endometriomas, there was statistical significance for IL-6, IL-8 and IL-10. The cutoff values for these cytokines were 5.3, 11 56.2 and 12.56, respectively. Conclusion: our results showed utility in serum concentrations of IL-6, IL-10 and IL-8 as parameters that differentiate endometriomas from ovarian malignancies, suggesting the feasibility of serum cytokine dosage as a biomarker to be used in the differential diagnosis of endometriosis during follow-up of these patients.