Affiliations: [a] Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan | [b] Department of Research and Development, Metallogenics Co., Ltd., Chiba, Japan
Correspondence:
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Corresponding author: Hiroshi Kobayashi, Department of Obstetrics and Gynecology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan. Tel.: +81 744 29 8877; Fax: +81 744 23 6557; E-mail: [email protected]
Abstract:
OBJECTIVE: The purpose of this study was to investigate cyst fluid levels of
total iron, heme iron and free iron in benign endometriotic cysts and
endometriosis-associated ovarian cancer (EAOC) and to demonstrate the
significance of these biomarkers in differential diagnosis between EAOC and
endometriotic cysts. METHODS: Cyst fluid samples were obtained from eleven patients with EAOC and
thirty-six women with benign endometriotic cysts at the time of surgery. RESULTS: The median (± SD) total iron levels for endometriotic cysts
and EAOC cysts were 244.4 ± 204.9 mg/L and 14.2 ± 36.6 mg/L,
respectively. EAOC patients had much lower levels of iron-related compounds
compared with endometriotic cyst samples (p< 0.001). When the total iron
results were analyzed using the receiver operating characteristics (ROC)
curve method, the optimum diagnostic cut-off point was 64.8 mg/L,
sensitivity was 90.9%, specificity was 100%, positive predictive value
(PPV) was 100%, and negative predictive value (NPV) was 97.3%. Patient
demographic characteristics such as tumor size, age at operation, parity and
menopause were not correlated with cyst fluid iron levels. CONCLUSIONS: We conclude for the first time that iron-related compounds are
important biomarkers that can predict malignant transformation with high
sensitivity and specificity for women with endometriosis.
