探讨血清炎性细胞因子白细胞介素(IL)-6、-1β及肿瘤坏死因子(TNF)-α、干扰素-γ在卵巢囊肿蒂扭转患者中的表达及诊断价值。

选择2011年1月至2014年12月河南省商丘市第一人民医院收治的疑似卵巢囊肿蒂扭转且行手术治疗的40例患者为研究对象，按照术中探查显示是否为卵巢囊肿蒂扭转，将其分为研究组(n＝23，术中确诊为卵巢囊肿蒂扭转患者)和对照组(n＝17，术中确诊为非卵巢囊肿蒂扭转患者)。采用酶联免疫吸附测定(ELISA)法检测40例患者肘静脉血血清炎性细胞因子IL-6、-1β及TNF-α、干扰素-γ表达水平，并对两组患者血清炎性细胞因子(IL-6、-1β及TNF-α、干扰素-γ)的检测结果进行统计学分析，并绘制受试者操作特征(ROC)曲线，计算各血清炎性细胞因子在诊断卵巢囊肿蒂扭转的临界值、敏感度、特异度、阳性预测值、阴性预测值及约登指数。本研究遵循的程序符合河南省商丘市第一人民医院人体试验委员会制定的伦理学标准，得到该委员会批准，研究征得受试对象的知情同意，并与之签订临床研究知情同意书。

研究组患者IL-6、-1β及TNF-α、干扰素-γ表达水平均高于对照组[IL-6：(10.92±0.63) pg/mL vs (10.20±0.58) pg/mL；IL-1β：(53.28±15.29) pg/mL vs (34.59±10.27) pg/mL；TNF-α：(8.96±1.50) pg/mL vs (8.02±1.34) pg/mL；干扰素-γ：(25.17±6.56) pg/mL vs (16.52±3.71) pg/mL]，并且差异均有统计学意义(t＝3.69，4.36，2.05，4.88；P＝0.000 1, 0.000 1, 0.005 3, 0.034)。通过绘制ROC曲线得出，IL-6与IL-1β曲线下面积分别为0.838与0.831，对卵巢囊肿蒂扭转诊断的敏感度分别为78.3%和91.3%，特异度分别为82.5%%和82.4%。

血清IL-6与IL-1β可作为卵巢囊肿蒂扭转的术前辅助诊断指标。

To investigate a possible role for serum inflammatory cytokines [interleukin (IL)-6, 1β and tumor necrosis factor (TNF)-α, interferon-γ] as pre-operative diagnosis index of ovarian cyst torsion.

From January 2011 to December 2014, a total of forty cases who were admitted to Shangqiu First People's Hospital with suspected clinical diagnosis of ovarian cyst torsion were prospectively assigned to the study. They were divided into two groups according to surgery examination, study group (n=23, ovarian cyst torsion patients) and control group (n=17, non-ovarian cyst torsion patients). Blood samples were drawn pre-operatively and examined for serum levels of IL-6, -1β and TNF-α, interferon-γ by enzyme-linked immunosorbent assay (ELISA). The levels of serum inflammatory cytokines, receiver operating characteristic (ROC) curve between two groups were analyzed. Meanwhile, the critical value, sensitivity, specificity, positive predictive value, negative predictive value and Youden's index of serum inflammatory cytokines in the diagnosis of ovarian cyst torsion were detected. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Shangqiu First People's Hospital in Henan Province. Informed consent was obtained from each participates.

Levels of IL-6, -1β and TNF-α, interferon-γ in study group were higher than those in group control[IL-6: (10.92±0.63) pg/mL vs (10.20±0.58) pg/mL; IL-1β: (53.28±15.29) pg/mL vs (34.59±10.27) pg/mL; TNF-α: (8.96±1.50) pg/mL vs (8.02±1.34) pg/mL; interferon-γ: (25.17±6.56) pg/mL vs (16.52±3.71) pg/mL], and all the differences were statistically significant (t=3.69, 4.36, 2.05, 4.88; P=0.000 1, 0.000 1, 0.005 3, 0.034). According to the ROC curve, the area under curve of IL-6, -1β were 0.838 and 0.831, the sensitivity of diagnosing ovarian cyst torsion were 78.3% and 91.3%, the specificity were 82.5% and 82.4%, respectively.

Elevated serum levels of IL-6 and IL-1β were associated with the occurrence of ovarian cyst torsion. In combination with vague clinical signs of ovarian cyst torsion, serum IL-6 and IL-1β could be the pre-operative diagnostic indices of ovarian cyst torsion.