Relationship between Cyst Fluid Concentrations of Iron and Severity of Dysmenorrhea in Patients with Ovarian Endometrioma
Relationship between Cyst Fluid Concentrations of Iron and Severity of Dysmenorrhea in Patients with Ovarian Endometrioma
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DOI：
10.1159/000514972
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发表时间：
2021-03
影响因子：
2.1
通讯作者：
Shogo Imanaka;S. Maruyama;Mai Kimura;Mika Nagayasu;N. Kawahara;Hiroshi Kobayashi
中科院分区：
文献类型：
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作者：
Shogo Imanaka;S. Maruyama;Mai Kimura;Mika Nagayasu;N. Kawahara;Hiroshi Kobayashi
目标与设计：子宫内膜异位症相关疼痛可由解剖结构扭曲以及环境因素如炎症和氧化应激引起。本研究的目的是探讨卵巢恶性肿瘤（OMA）患者痛经的严重程度与囊肿液（CF）中铁（包括总铁、血红素铁和游离铁）浓度之间的关系。方法：奈良医科大学附属医院妇科在2013年至2019年期间入组了83例组织学诊断为OMA的患者。根据痛经的严重程度将患者分为4组：无痛组、轻度组、中度组和重度组。采用电感耦合等离子体发射光谱法测定铁离子浓度。结果如下：4组之间在诊断时年龄、术前CA125、术前CA19 - 9、囊肿大小和肿瘤偏侧性（单侧或双侧）等变量方面无显著差异。痛经的严重程度与总铁（p <0.001）和血红素铁（p = 0.016）浓度呈正相关。多元回归分析显示，总铁的CF浓度（风险比18.75，95%置信区间：2.26 - 155.35，p = 0.007）是一个显着的独立变量与痛经的严重程度。受试者工作特征曲线分析表明，总铁超过290.8mg/L与重度痛经相关，敏感性为90.9%，特异性为65.7%。局限性：本研究排除了子宫腺肌病、浅表性子宫内膜异位症或深部子宫内膜异位症患者，导致病例数较少。铁水平不能与使用r-ASRM评分的子宫内膜异位症分期进行比较。结论：没有明确的证据表明铁可以预测糖尿病相关疼痛的严重程度。然而，铁可能与痛经密切相关。
Objectives and Design: Endometriosis-related pain can be caused by anatomical distortions as well as environmental factors such as inflammation and oxidative stress. The aim of this study is to investigate the relationship between the severity of dysmenorrhea in patients with ovarian endometrioma (OMA) and cyst fluid (CF) concentrations of irons, including total iron, heme iron, and free iron. Method: Eighty-three patients who were histologically diagnosed with OMA were enrolled in the Department of Gynecology, Nara Medical University Hospital, between 2013 and 2019. The patients were divided into 4 groups according to the severity of dysmenorrhea: no pain, mild, moderate, and severe. Iron concentration was measured by the inductively coupled plasma optical emission spectrometry method. Results: There were no significant differences among the 4 groups in variables such as age at diagnosis, preoperative CA125, preoperative CA19-9, cyst size, and tumor laterality (unilateral or bilateral). There was a positive correlation between the severity of dysmenorrhea and total iron (p < 0.001) and heme iron (p = 0.016) concentrations. Multiple regression analyses revealed that the CF concentration of total iron (hazard ratio 18.75, 95% confidence interval: 2.26–155.35, p = 0.007) was a significant independent variable associated with the severity of dysmenorrhea. A receiver operating characteristic curve analysis showed that a total iron exceeding 290.8 mg/L was associated with severe dysmenorrhea with a sensitivity of 90.9% and a specificity of 65.7%. Limitations: This study excluded patients with adenomyosis, superficial endometriosis, or deep endometriosis, resulting in a smaller number of cases. Iron levels could not be compared to the endometriosis stage using the r-ASRM score. Conclusions: There is no clear evidence that iron predicts the severity of endometriosis-related pain. However, iron may be closely associated with dysmenorrhea.