Dietrich Jennifer E, Adeyemi Oluyemisi, Hakim Julie, Santos Xiomara, Bercaw-Pratt Jennifer L, Bournat Juan C, Chen Ching H, Jorgez Carolina J
Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas.
J Pediatr Adolesc Gynecol. 2017 Oct;30(5):571-577. doi: 10.1016/j.jpag.2017.04.002. Epub 2017 Apr 27.
Paratubal cysts (PTCs) occur in 7%-10% of women, regardless of age. Although common, PTCs often are found incidentally because of the potential for these cysts to be asymptomatic. The specific aims of the study were to determine if PTC number and size correlated with signs of hyperandrogenism and obesity, as well as to investigate the molecular profiles of these PTCs in samples derived from female adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A prospective cohort study was performed in a single children's hospital. Girls 18 years of age or younger who underwent surgery for PTC suspected on the basis of the presence of a persistent adnexal cyst on imaging or a concern for adnexal torsion involving a cyst were consented to participate in the study.
Nineteen patients met enrollment criteria with a mean age at menarche of 11.2 ± 1.3 years. Most of the patients (84%; n = 16/19) had adnexal torsion at the time of diagnosis of PTC. Irregular menses and hirsutism was found in 52.6% (n = 10/19) of the patients, among whom 36.8% (n = 7/19) were obese. The mean PTC size was 10.4 ± 4.3 cm with 57.9% (n = 11/19) of the cohort having more than 1 PTC. When patients were compared on the basis of their body mass index, the size of PTCs was significantly larger in the overweight/obese group. The wingless-type (WNT) signaling members catenin beta 1 (CTNBB1) and wingless-type MMTV integration site family, member 7A (WNT7A) were upregulated in 86% (n = 12/14) and 79% (n = 11/14) of the patients, respectively. WNT7A was significantly upregulated in girls with 1 cyst and low body mass index.
A correlation exists between obesity, cyst size, and hyperandrogenism. Activation of the WNT/CTNBB1 pathway via WNT7A might play a role in PTC development.
副输卵管囊肿（PTCs）在7% - 10%的女性中出现，与年龄无关。尽管常见，但PTCs通常是偶然发现的，因为这些囊肿可能无症状。本研究的具体目的是确定PTC的数量和大小是否与高雄激素血症和肥胖的体征相关，以及研究这些PTCs在来自女性青少年样本中的分子特征。
设计、地点、参与者、干预措施及主要观察指标：在一家儿童医院进行了一项前瞻性队列研究。对18岁及以下因影像学检查发现持续性附件囊肿或担心附件扭转涉及囊肿而疑似PTC并接受手术的女孩，征得其同意参与研究。
19名患者符合入组标准，初潮时的平均年龄为11.2±1.3岁。大多数患者（84%；n = 16/19）在诊断PTC时伴有附件扭转。52.6%（n = 10/19）的患者出现月经不规律和多毛，其中36.8%（n = 7/19）为肥胖患者。PTC的平均大小为10.4±4.3厘米，57.9%（n = 11/19）的队列中有多个PTC。根据体重指数对患者进行比较时，超重/肥胖组的PTC大小明显更大。无翼型（WNT）信号成员β-连环蛋白1（CTNBB1）和无翼型MMTV整合位点家族成员7A（WNT7A）分别在86%（n = 12/14）和79%（n = 11/14）的患者中上调。WNT7A在有1个囊肿且体重指数低的女孩中显著上调。
肥胖、囊肿大小和高雄激素血症之间存在关联。通过WNT7A激活WNT/CTNBB1途径可能在PTC的发生发展中起作用。
