Cabiscuelas Charmaine A, Li Lan Ying, Seon Ki Eun, Kim Yup, Lee Jae Hoon, Nam Eun Ji, Lee Jung-Yun, Kim Sunghoon, Kim Young Tae, Kim Sang Wun
Women's Cancer Center, Yonsei Cancer Center, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
J Menopausal Med. 2021 Dec;27(3):168-174. doi: 10.6118/jmm.21031.
This study compared serum anti-Mullerian hormone (AMH) levels in endometriotic cysts (ECs) with those in non-ECs and analyzed changes thereof after single-port laparoscopic (SPL) ovarian cyst enucleation using vasopressin injection.
In total, 180 patients (EC group, n = 112; non-EC group, n = 68) who underwent SPL ovarian cyst enucleation were retrospectively reviewed. Their AMH levels were checked preoperatively, on postoperative day 10 (POD10), and on postoperative month 3 (POM3). Changes in AMH levels were analyzed according to tumor type and vasopressin use.
The median initial and postoperative serum AMH levels in the EC group were significantly lower than those in the non-EC group (preoperation: 2.0 vs 3.8 ng/mL, < 0.001; POD10: 1.0 vs 3.2 ng/mL, < 0.001; POM3: 1.2 vs 3.6 ng/mL, < 0.001). The postoperative decrease in AMH levels was higher in the EC group than the non-EC group on POD10 (0.8 vs 0.5 ng/mL, = 0.011) but not on POM3 (0.7 vs 0.5 ng/mL, = 0.164). Vasopressin injection during EC enucleation had no significant effect on the decrease in AMH levels on POD10 (vasopressin group vs non-vasopressin group: 1.0 vs 0.8 ng/mL, = 0.253) and POM3 (vasopressin group vs nonvasopressin group: 1.4 vs 1.1 ng/mL, = 0.242).
AMH levels were lower at baseline and had higher decreasing rates after SPL surgery in the EC group relative to the non-EC group. Vasopressin injection might not protect the ovary from the postoperative decrease in AMH levels.
本研究比较了子宫内膜异位囊肿（ECs）与非子宫内膜异位囊肿患者的血清抗苗勒管激素（AMH）水平，并分析了使用加压素注射的单孔腹腔镜（SPL）卵巢囊肿剥除术后AMH水平的变化。
回顾性分析了180例行SPL卵巢囊肿剥除术的患者（EC组，n = 112；非EC组，n = 68）。在术前、术后第10天（POD10）和术后第3个月（POM3）检查他们的AMH水平。根据肿瘤类型和加压素使用情况分析AMH水平的变化。
EC组术前和术后血清AMH水平的中位数显著低于非EC组（术前：2.0 vs 3.8 ng/mL，<0.001；POD10：1.0 vs 3.2 ng/mL，<0.001；POM3：1.2 vs 3.6 ng/mL，<0.001）。EC组术后第10天AMH水平的下降幅度高于非EC组（0.8 vs 0.5 ng/mL，=0.011），但术后第3个月无差异（0.7 vs 0.5 ng/mL，=0.164）。EC剥除术中注射加压素对术后第10天（加压素组vs非加压素组：1.0 vs 0.8 ng/mL，=0.253）和术后第3个月（加压素组vs非加压素组：1.4 vs 1.1 ng/mL，=0.242）AMH水平的下降无显著影响。
与非EC组相比，EC组基线时AMH水平较低，SPL手术后下降率较高。注射加压素可能无法保护卵巢免受术后AMH水平下降的影响。
