Effects of chocolate cyst fluid on endometrioma cell growth in culture

Velasco

et al. 2009

Gynecol Obstet Invest

Background: To analyze the therapeutic results of recombinant interleukin-2 (rIL-2) left in the cysts after transvaginal ultrasound (US)-guided drainage of endometriomas as an alternative to surgery. Methods: Prospective and randomized clinical trial. A total of 25 consecutive patients were included. Two transvaginal US-guided punctures were performed, and 3 million IU of rIL-2 were left in the aspirated cysts once (group I) or both (group II) times according to randomization. Main Outcome Measures: Clinical results, prevented surgeries, and recurrences. Results: Results were moderate or good in only 16% of subjects at 3 months and in 33% of subjects at 6 months after treatment in group I; these numbers were 66 and 33%, respectively, in group II. Differences were not statistically significant. However, the evolution of symptoms, endometriomas, and CA-125 revealed the low efficacy of rIL-2 left intracyst as well as a poor control of the clinical manifestations. After 1 year, 20% (group I) and 73% (group II) of patients had to be operated; after 2 years, these numbers were 55 and 82%, respectively. Conclusions: Treatment of endometriomas with transvaginal US-guided drainage and rIL-2 left in the cysts, without using endometrial suppressive therapy with GnRH analogues as done in previous studies, has low efficacy. Recurrences are even more frequent after the use of two rIL-2 doses.

Section: Discussionmentioning

confidence: 99%

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage and Recombinant Interleukin-2 Left in the Cysts: A Third Clinical Trial

Velasco

et al. 2009

Gynecol Obstet Invest

“…Thus the temporary suppression of endometrial activity and the local activation of cytolitic activity using rIL-2 could be a good approach for the treatment of severe endometriosis. In addition, a possible inductor role of the chocolate-type cyst fluid on endometrioma cell growth has been suggested [23]. Therefore its aspiration could also contribute to curing endometriosis.…”

Section: Discussionmentioning

confidence: 99%

GnRH Analogues, Transvaginal Ultrasound-Guided Drainage and Intracystic Injection of Recombinant Interleukin-2 in the Treatment of Endometriosis

Quereda

Gómez‐Torres

et al. 2003

Gynecol Obstet Invest

We performed a double-blind, randomised controlled trial to evaluate the results of ultrasound-guided aspiration of endometriomas under the effect of GnRH analogues and a possible additional beneficial effect by leaving 600,000 IU of recombinant interleukin-2 (rIL-2) in the cysts. Twenty-four women with endometriosis-related symptoms, increased values of CA-125 and transvaginal ultrasonography showing endometriomas >3 cm who were initially sent to us for laparotomy and conservative surgery for endometriosis were included. Main outcome measures were severity of symptoms, size and percentage of echographical reduction of endometriomas and CA-125 levels after 2 menses post-GnRH analogues. Secondary outcome measures were the time until recurrence of abnormal parameters and the need for surgery after treatment. We found moderate clinical results after treatment with drainage plus GnRH analogues and significantly improved results in women having received rIL-2 intracystically. There were no side effects. Two out of 3 previously infertile patients became pregnant after therapy. Though the rates of recurrence of endometriomas ≧3 cm were similar in both groups, the period until recurrence was significantly greater when rIL-2 was used, and the rates of recurrence of symptoms and increased CA-125 values were also significantly lower in patients who received rIL-2. Surgery was finally performed on 10 patients (4 with and 6 without previous rIL-2 treatment) during follow-up (30 ± 12.7 months). These findings led to the conclusion that transvaginal ultrasound-guided puncture and aspiration of endometriomas under endometrial suppressive therapy with GnRH analogues have some value for endometriosis treatment, improving the clinical manifestations and avoiding some surgical therapies, and that rIL-2 left in the cyst increases these beneficial effects significantly.

J of Obstet and Gynaecol

“…Previous studies have shown that estrogen can stimulate and maintain the growth and proliferation of ectopic endometrial tissue. Estrogen secretion decreases after 35 years of age . Liu et al .…”

Section: Discussionmentioning

confidence: 99%

Correlation between ovarian chocolate cyst and serum carbohydrate antigen 125 level and the effect of ultrasound‐guided interventional sclerotherapy on serum carbohydrate antigen 125 level

Wang

Cai

Xiao

et al. 2014