Cyst fluid hemoglobin species in endometriosis and its malignant transformation: The role of metallobiology

Iwabuchi T, Takuya Iwabuchi, Chiharu Yoshimoto, Yoshimoto C, Shigetomi H, Hiroshi Shigetomi, Kobayashi H, Hiroshi Kobayashi
Oncology letters · 2016 · vol. 11(5) , pp. 3384–3388 · doi:10.3892/ol.2016.4383 · PMID:27123121 · PMC4841012 · W2320663285
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The 620/580 nm absorption ratio of cyst fluid, indicating methemoglobin levels, differentiated endometriosis-associated ovarian cancer from benign cysts with high sensitivity and specificity.

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This study assessed whether hemoglobin (Hb) species in ovarian cyst fluid differ between benign endometriotic cysts and endometriosis-associated ovarian cancer. Using electronic absorption spectroscopy and a 620/580 nm ratio as a surrogate for the methemoglobin (metHb)/(oxyhemoglobin+metHb) ratio, the authors compared cyst fluid from 8 patients with endometriosis-associated ovarian cancer and 35 patients with benign endometriotic cysts, defining an optimal cutoff via ROC analysis. The 620/580 nm ratio was lower in the cancer group than in benign cysts (0.389±0.266 vs. 0.666±0.188), and with a cutoff of 0.35 the ratio showed high specificity and positive predictive value, though sensitivity was 62.5. The study’s limitations include the small EAOC sample size and the use of a spectroscopic surrogate ratio rather than direct characterization of all Hb species. This paper is centrally about endometriosis — it evaluates cyst fluid hemoglobin species as indicators of malignant transformation in endometriosis-associated ovarian cancer.

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Abstract

The aim of the present study was to assess the relative concentrations of hemoglobin (Hb) species in endometriosis as a possible indicator of malignancy. Electronic absorption spectroscopy was employed to quantify the Hb species present in the cyst fluid collected from 8 patients with endometriosis-associated ovarian cancer (EAOC), and compared with those present in the cyst fluid of 35 patients with benign endometriotic cysts. The 620/580 nm ratio in the electronic absorption spectrum, which was used as a surrogate indicator of the methemoglobin (metHb)/(oxyhemoglobin+metHb) ratio, was measured in each cyst fluid by ultraviolet/visible grating spectrophotometric microplate reader. The optimal cutoff value was defined according to the analysis of receiver operating characteristic (ROC) curve. The sensitivity and specificity of detection were calculated on the basis of the cutoff value to differentiate EAOC from endometriosis. The 620/580 nm ratio of cyst fluid in EAOC patients was much lower than that measured in women with benign cysts (0.389±0.266 vs. 0.666±0.188, P=0.021). ROC curve analysis performed using 0.35 as the optimal cutoff value indicated that the 620/580 nm ratio had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value of 62.5, 100.0, 100.0 and 92.1%, respectively, in the diagnosis of EAOC. In conclusion, metHb is one of the most abundant Hb species in benign cysts, and the absorption 620/580 nm ratio of cyst fluid exhibits high specificity and PPV as a surveillance test for the early detection of malignant transformation of endometriosis. Thus, metallobiology highlights diverse features involved in Hb homeostasis and the pathogenesis of malignant transformation of endometriosis.
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Print ISSN: 1792-1074 Online ISSN: 1792-1082 International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease. International Journal of Oncology is an international journal devoted to oncology research and cancer treatment. Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery. Oncology Reports is an international journal devoted to fundamental and applied research in Oncology. Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine. Oncology Letters is an international journal devoted to Experimental and Clinical Oncology. Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology. International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis. Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology. Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition. Publishes open-access research on using epigenetics to advance understanding and treatment of human disease. An International Open Access Journal Devoted to General Medicine. Article - Authors: - Pages: 3384-3388|Published online on: March 29, 2016https://doi.org/10.3892/ol.2016.4383 - Expand metrics + The aim of the present study was to assess the relative concentrations of hemoglobin (Hb) species in endometriosis as a possible indicator of malignancy. Electronic absorption spectroscopy was employed to quantify the Hb species present in the cyst fluid collected from 8 patients with endometriosis‑associated ovarian cancer (EAOC), and compared with those present in the cyst fluid of 35 patients with benign endometriotic cysts. The 620/580 nm ratio in the electronic absorption spectrum, which was used as a surrogate indicator of the methemoglobin (metHb)/(oxyhemoglobin+metHb) ratio, was measured in each cyst fluid by ultraviolet/visible grating spectrophotometric microplate reader. The optimal cutoff value was defined according to the analysis of receiver operating characteristic (ROC) curve. The sensitivity and specificity of detection were calculated on the basis of the cutoff value to differentiate EAOC from endometriosis. The 620/580 nm ratio of cyst fluid in EAOC patients was much lower than that measured in women with benign cysts (0.389±0.266 vs. 0.666±0.188, P=0.021). ROC curve analysis performed using 0.35 as the optimal cutoff value indicated that the 620/580 nm ratio had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value of 62.5, 100.0, 100.0 and 92.1%, respectively, in the diagnosis of EAOC. In conclusion, metHb is one of the most abundant Hb species in benign cysts, and the absorption 620/580 nm ratio of cyst fluid exhibits high specificity and PPV as a surveillance test for the early detection of malignant transformation of endometriosis. Thus, metallobiology highlights diverse features involved in Hb homeostasis and the pathogenesis of malignant transformation of endometriosis. Copy and paste a formatted citation Spandidos Publications style Iwabuchi T, Yoshimoto C, Shigetomi H and Kobayashi H: Cyst fluid hemoglobin species in endometriosis and its malignant transformation: The role of metallobiology. Oncol Lett 11: 3384-3388, 2016. APA Iwabuchi, T., Yoshimoto, C., Shigetomi, H., & Kobayashi, H. (2016). Cyst fluid hemoglobin species in endometriosis and its malignant transformation: The role of metallobiology. Oncology Letters, 11, 3384-3388. https://doi.org/10.3892/ol.2016.4383 MLA Iwabuchi, T., Yoshimoto, C., Shigetomi, H., Kobayashi, H."Cyst fluid hemoglobin species in endometriosis and its malignant transformation: The role of metallobiology". Oncology Letters 11.5 (2016): 3384-3388. Chicago Iwabuchi, T., Yoshimoto, C., Shigetomi, H., Kobayashi, H."Cyst fluid hemoglobin species in endometriosis and its malignant transformation: The role of metallobiology". Oncology Letters 11, no. 5 (2016): 3384-3388. https://doi.org/10.3892/ol.2016.4383

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