{"paper_id":"c5c6df39-4d8c-4072-8953-13daa1073eae","body_text":"Risk factors for recurrence of ovarian endometriomas after surgical treatment: retrospective cohort study\nhttps://doi.org/10.47093/2218-7332.2020.11.4.60-71\nAbstract\nAim. To identify risk factors for recurrence of ovarian endometriomas after surgical treatment.\nMaterials and methods. The retrospective cohort study included 82 patients operated on for the first time for ovarian endometriomas, the follow-up period was 30 months. The recurrence developed in 19 patients (group 1), in 63 the recurrence was not diagnosed (group 2). Data prior to surgery (clinical characteristics, level CA-125), during surgery (cytokine concentration in peritoneal fluid, immunohistochemical analysis in capsule of ovarian endometriomas), postoperative therapy were evaluated as risk factors for recurrence. The Mann-Whitney U-test, the Fisher exact test was used to compare the groups. Specificity, sensitivity, accuracy, AUC ROC and threshold values were calculated.\nResults. The recurrence rate of ovarian endometriomas was 23%. There were no differences between groups according to age, proportion of smokers, body mass index, gynecological anamnesis, obstetric status and postoperative hormone therapy. Preoperative concentrations of CA-125 in group 1 were higher than in group 2: 62.5 U/ml [40.7; 112.3] vs 40.3 U/ml [20.3; 68.8], р < 0.05. The concentration of IL-6, IL-8, TNFα, IL-1β, IL-17, VEGF, MCP 1 in peritoneal fluid taken during surgery was statistically significantly higher in group 1. The highest AUC ROC was received for VEGF 0.875 (0.778–0.973) and IL-8 0.953 (0.896–1.009). For VEGF the threshold value was 125.6 pg/ml, sensitivity 100%, specificity 71%, accuracy 79.8%. For IL-8 the threshold value was 128.78 pg/ml, sensitivity 93%, specificity 87.1%, accuracy 88.9%. In group 1, higher expression values of VEGF and CD34 angiogenesis markers in ovarian endometriomas were recorded. The highest AUC ROC was noted for CD34 — 0.844 (0.683–1.000), threshold value was 2.5%, sensitivity 90%, specificity 75%, accuracy 80.8%.\nConclusion. Risk factors for recurrence of ovarian endometriomas after operative treatment include VEGF and IL-8 levels in peritoneal fluid and expression of CD34 in the capsule.\nAbout the Authors\nT. S. KachalinaRussian Federation\nTatyana S. Kachalina, Dr. of Sci. (Medicine), Professor, Department of Obstetrics and Gynecology\n10/1, Minin and Pozharsky Sq., Nizhny Novgorod, 603005\nM. E. Bogatova\nRussian Federation\nMarina E. Bogatova, obstetrician-gynecologist, City Clinical Hospital No. 29\n13B, Tropinina str., Nizhny Novgorod, 603137\n+7 (905) 010-03-79\nS. S. Kuznetsov\nRussian Federation\nSergey S. Kuznetsov, Dr. of Sci. (Medicine), Associate Professor, Head of the Anatomical pathology Department\n190, Rodionova str., Nizhny Novgorod, 603126\nV. F. Lazukin\nRussian Federation\nValeriy F. Lazukin, Cand. of Sci. (Biology), Associate Professor of the Department of Medical Physics and Informatics\n10/1, Minin and Pozharsky Sq., Nizhny Novgorod, 603005\nReferences\n1. Protasova A.EH., Vandeeva E.N., Kuz’mina N.S. Ehndometrioz — dobrokachestvennoe zabolevanie? Sovremennye diskussionnye aspekty ehndometrioz-assotsiirovannykh opukholei yaichnika. [Endometriosis — a benign disease? Modern debatable aspects of endometriosis-associated ovarian tumors]. Russian Journal of Human Reproduction = Problemy reproduktsii. 2016; 22 (5): 98– 109 (In Russian). https://doi.org/10.17116/repro201622598-109\n2. Popova O. S. Kletki immunnoi sistemy kak biomarkery v diagnostike ehndometrioza. [Cells of the immune system as biomarkers in the diagnosis of endometriosis]. 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