Yoshimoto Chiharu, Iwabuchi Takuya, Shigetomi Hiroshi, Kobayashi Hiroshi
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Department of Research and Development, Metallogenics Co., Ltd., Chiba, Japan.
Cancer Biomark. 2015;15(4):493-9. doi: 10.3233/CBM-150484.
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.
Cyst fluid samples were obtained from eleven patients with EAOC and thirty-six women with benign endometriotic cysts at the time of surgery.
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.
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.
本研究旨在调查良性子宫内膜异位囊肿及子宫内膜异位症相关卵巢癌（EAOC）中总铁、血红素铁和游离铁的囊液水平，并阐明这些生物标志物在EAOC与子宫内膜异位囊肿鉴别诊断中的意义。
手术时从11例EAOC患者和36例患有良性子宫内膜异位囊肿的女性中获取囊液样本。
子宫内膜异位囊肿和EAOC囊肿的总铁水平中位数（±标准差）分别为244.4±204.9mg/L和14.2±36.6mg/L。与子宫内膜异位囊肿样本相比，EAOC患者的铁相关化合物水平低得多（p<0.001）。当使用受试者工作特征（ROC）曲线法分析总铁结果时，最佳诊断切点为64.8mg/L，敏感性为90.9%，特异性为100%，阳性预测值（PPV）为100%，阴性预测值（NPV）为97.3%。患者的人口统计学特征，如肿瘤大小、手术年龄、产次和绝经情况，与囊液铁水平无关。
我们首次得出结论，铁相关化合物是重要的生物标志物，对患有子宫内膜异位症的女性具有高敏感性和特异性，可预测恶性转化。
