Obstet Gynecol Sci.  2018 May;61(3):386-394. 10.5468/ogs.2018.61.3.386.

Combination of clinical and laboratory characteristics may serve as a potential diagnostic marker for torsion on mature cystic teratomas

• Lee JY
• Shin W
• Kim JS
• Park JH
• Cho S

• KMID: 2416128
• DOI: http://doi.org/10.5468/ogs.2018.61.3.386

Abstract

OBJECTIVE
The objective of this study was to evaluate clinical and laboratory characteristics of torsion on mature cystic teratomas (MCTs). In addition, we examined whether these factors could be helpful in diagnosing MCT torsion.
METHODS
A retrospective medical record review was conducted for 384 patients who had undergone surgery and histologically verified ovarian MCTs at single university hospital between July 2006 and May 2017. Patients with or without torsion groups were compared with respect to clinical presentation, laboratory findings and surgical course. In addition, statistically significant indicators of the factors were additionally evaluated for diagnostic value.
RESULTS
White blood cell (WBC) count, neutrophil count, neutrophil to lymphocyte (N/L) ratio, and tumor size were higher in the torsion group (n=24) than in the control group (n=360; P≤0.005 for all). The age was younger in the torsion group than in the control (P=0.009). In the area under the curve (AUC) of the 5 factors obtained by univariate and multivariate logistic regression, the age was 0.657, the WBC count was 0.838, the neutrophil count was 0.806, the N/L ratio was 0.725, and the cyst size was 0.705. Receiver operating characteristic analysis indicated that the AUC for the combined use of age, WBC count, neutrophil count, N/L ratio, and tumor size was 0.898 (95% confidence interval, 0.833-0.962; P < 0.001).
CONCLUSION
The combined measurement of age, WBC count, neutrophil count, N/L ratio, and tumor size may be used as a potential diagnostic marker for the torsion on MCTs.

Keyword

Teratoma; Leukocyte; Neoplasms

MeSH Terms

Area Under Curve
Humans
Leukocytes
Logistic Models
Lymphocytes
Medical Records
Neutrophils
Retrospective Studies
ROC Curve
Teratoma*

Figure

• 

  Fig. 1 Receiver operating characteristic curves affecting variables to diagnose the mature cystic teratoma with torsion. WBC, white blood cell; N/L ratio, neutrophil to lymphocyte ratio. a)This consists of the age, WBC count, neutrophil count, N/L ratio, and cyst size.

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  Fig. 2 Comparison between ovarian tissue necrosis and consumed time from acute abdominal pain onset to surgery. There was a significant difference in the total consumed time from acute abdominal pain onset to surgery (time from onset). When surgery occurred in early time, ovarian necrosis did not occur. Otherwise, ovarian necrosis was existed in late time (15.4±18.8 and 62.7±26.7 hours, respectively). a)P<0.001.

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