Department of Obstetrics and Gynecology, University of Pecs, School of Medicine, 17 Edesanyak Str., Pecs, Hungary.
Member of the HAS-UP Human Reproduction Scientific Research Group, Hungarian Academy of Sciences (HAS), Pecs, Hungary.
J Ovarian Res. 2020 Mar 5;13(1):25. doi: 10.1186/s13048-020-00624-9.
Ovarian hyperstimulation syndrome (OHSS) is a rare, yet severe, iatrogenic complication of ovulation induction therapy during assisted reproductive procedures. Our group previously detected atypical cells in the ascitic fluid of OHSS patients, although no malignancy developed during follow up. Here, the aim was to perform a comparative analysis of the cytokines present in the abdominal fluid of patients affected by OHSS versus patients with advanced ovarian cancer, a benign adnexal mass, or ovarian endometriosis.
This prospective, non-randomized study was conducted at the Clinical Center of the University of Pecs Department of Obstetrics and Gynecology/Reproductive Center between October 2016 and March 2018. Abdominal fluid samples were obtained from 76 patients and subjected to Luminex analysis. The samples were collected from patients with OHSS (OHSS; n = 16), advanced ovarian cancer (OC; n = 22), a benign adnexal mass (BAM; n = 21), or ovarian endometriosis (EM; n = 17). Data were subjected to the non-parametric Kruskal-Wallis test and Spearman's rank correlation coefficient to identify statistical differences between the four study groups.
Leukocytosis and hemoconcentration were detected in the peripheral blood of OHSS patients. Abdominal fluid analysis further revealed significantly higher levels of interleukin (IL)-6, IL-8, IL-10, and transforming growth factor (TGF)-β in both the OHSS and OC groups compared to the BAM and EM groups. The highest concentration of vascular endothelial growth factor (VEGF) was detected in the OC group, while a significantly lower level was detected in the OHSS group. Moreover, VEGF levels in OC and OHSS groups were significantly elevated compared to the levels in the BAM and EM groups.
Vasoactive and hematogenic cytokines were present at higher levels in both the OHSS and OC abdominal fluid samples compared to the fluid samples obtained from the peritoneal cavity of the BAM patients. It is possible that these cytokines play an important role in the formation of ascites.
卵巢过度刺激综合征（OHSS）是辅助生殖过程中排卵诱导治疗的一种罕见但严重的医源性并发症。我们的团队之前在 OHSS 患者的腹水样本中检测到了非典型细胞，尽管在随访期间没有发展为恶性肿瘤。在这里，目的是对患有 OHSS 的患者与患有晚期卵巢癌、良性附件肿块或卵巢子宫内膜异位症的患者的腹水细胞因子进行比较分析。
这项前瞻性、非随机研究于 2016 年 10 月至 2018 年 3 月在佩奇大学临床中心妇产科/生殖中心进行。从 76 名患者中采集腹水样本，并进行 Luminex 分析。样本采集自 OHSS 患者（OHSS；n=16）、晚期卵巢癌患者（OC；n=22）、良性附件肿块患者（BAM；n=21）或卵巢子宫内膜异位症患者（EM；n=17）。数据采用非参数 Kruskal-Wallis 检验和 Spearman 秩相关系数进行分析，以确定四个研究组之间的统计学差异。
OHSS 患者外周血白细胞增多和血液浓缩。腹水分析进一步显示，与 BAM 和 EM 组相比，OHSS 和 OC 组的白细胞介素（IL）-6、IL-8、IL-10 和转化生长因子（TGF）-β水平显著升高。OC 组血管内皮生长因子（VEGF）浓度最高，而 OHSS 组浓度显著降低。此外，OC 和 OHSS 组的 VEGF 水平明显高于 BAM 和 EM 组。
与 BAM 患者腹腔液样本相比，OHSS 和 OC 腹水样本中的血管活性和造血细胞因子水平均升高。这些细胞因子可能在腹水形成中发挥重要作用。
