Changes in Peripheral Blood as Manifestation of Disorders in the Mononuclear Phagocyte and Platelet System in Endometriosis

Abstract

Background. According to modern knowledge, macrophages and platelets support the growth and development of endometrioid heterotopia, thereby maintaining its survival under unsuitable conditions.Objectives. To carry out a comparative analysis of blood tests with a particular focus on platelet and monocyte count in patients suffering from various forms of endometriosis and those with functional ovarian cysts before and after radical surgical treatment.Methods. Retrospective data on platelet and monocyte count were retrieved from the medical histories of patients included in the study. Blood test results obtained before and after radical surgery were analysed. The presence of concomitant gynaecological pathologies was taken into account. Statistical data were processed using the Kruskal-Wallis test (H), Mann—Whitney criterion (U), Spearman rank correlation criterion (R) and Chi-square criterion.Results. The research and control groups comprised 115 patients with endometrioid heterotopias of various localities and 28 patients with yellow body and follicular cysts, respectively. In both groups, the platelet count did not exceed the upper limit of normal values. In the control group, the platelet count below normal values was more common in patients both before (Chi square =10.35 (df = 1); p < 0.05) and after operation (Chi square =12.01; (df = 1); p < 0.05). A comparison of blood test parameters in patients with endometrioid heterotopias of different localities showed ovarian endometriosis to be characterised by the largest platelet count, with this value successively decreasing in patients with adenomyosis, pelvic peritoneal endometriosis and scar endometriosis. Monocyte count was significantly higher (U = 110, p < 0.05) in endometriosis associated with concomitant gynaecological pathologies, while platelet count did not depend on their presence (U = 824, p > 0.05). A comparison of platelet count values in the control group and the group of ovarian endometrioid cysts showed their significantly higher values in the latter group (U = 800.5, p < 0.05). After radical surgery, the number of platelets in both groups did not significantly differ (U = 833.5, p > 0.05). In addition, a moderate positive correlation was found between platelet count and monocyte count in patients with endometriosis before surgery (R = 0.42; p < 0.05).Conclusion. The obtained results indicate quantitative changes in the system of mononuclear phagocytes and platelets in patients with endometriosis. These pathogenetically justified changes are specific to endometriosis, which make them a useful criterion for clarifying the genesis of ovarian cysts at the preoperative stage.