Is the Measurement of Serum Ischemia-Modified Albumin the Best Test to Diagnose Ovarian Torsion?

Abstract

Aim: The aim of this study is to evaluate the diagnostic value of serum oxidative stress marker levels (ischemia-modified albumin, IMA; malondialdehyde, MDA) and total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) levels that occur in ovarian torsion and to determine the threshold value of these markers in the diagnosis of ovarian torsion. Methods: In this prospective case-control study, 34 women (the study group) with acute pelvic pain (20 with and 14 without ovarian torsion) and 40 control subjects were included. The diagnosis of ovarian torsion was confirmed with laparoscopy in all cases. Preoperative serum samples were collected in the study group. Serum oxidative stress marker levels (IMA and MDA) and TOS, TAS and OSI levels were measured. Results: Serum MDA, TOS and IMA concentrations were significantly higher in women with ovarian torsion than in the healthy control group. However, serum TAS, TOS and OSI concentrations were significantly higher in women without ovarian torsion than within the healthy control group. Only IMA significantly distinguished patients with or without ovarian torsion. The best IMA value, according to the receiver operating characteristic curve, was 0.7045 absorbance units, with 90.00% sensitivity and 92.31% specificity. The patients in the ovarian torsion group had significantly lower serum TAS and OSI levels compared with patients without ovarian torsion. Conclusion: The elevated serum IMA levels with high sensitivity-specificity values observed in women with ovarian torsion seem to have a potential role as a serum marker in the preoperative diagnosis of ovarian torsion in emergency settings.

Use of cancer antigen 125, cancer antigen 19‐9, and the neutrophil‐to‐lymphocyte ratio to diagnose mature cystic teratoma with torsion

“…Ovarian ischemia–reperfusion injury owing to twisting and subsequent release of the MCT is the main pathophysiological cause of torsion . Previous studies have investigated various inflammatory mechanisms that could be involved in this process, such as mean platelet volume or cytokine expression . In the present study, white blood cell, neutrophil, and lymphocyte counts were all markedly higher in the torsion group than in the control group.…”

The Role of Ischemia Modified Albumin and D‐dimer as Early or Late Biochemical Markers in Ovarian Torsion

“…Only IMA levels were able to discriminate the presence or absence of torsion. In patients operated due to ovarian torsion, the best IMA cut‐off value in the IMA characteristic curve was 0.7045 absorbance unit (ABSU) with sensitivity and specificity of 90 % and 92.31 %, respectively …”

Correlation between ischemia-modified albumin and Ranson score in acute pancreatitis

“…[2,26,27] In one of those, serum levels of oxidative stress markers including IMA were found to be higher in patients with acute appendicitis than in healthy individuals. However, the authors found no correlation between the pathological extent of acute appendicitis and oxidative stress markers.…”