title: The accuracy of serum interleukin-6 and tumour necrosis factor as markers for ovarian torsion.
abstract: BACKGROUND
  The aim of this study was to investigate a possible role for interleukin-6 (IL-6) and tumour necrosis factor (TNF-alpha) as pre-operative markers for the diagnosis of ovarian torsion.
  
  
  METHODS
  Twenty consecutive patients admitted to the gynaecological emergency room with suspected clinical diagnosis of ovarian torsion were prospectively assigned to the study. Blood samples were drawn pre-operatively and examined for serum concentrations of IL-6 and TNF-alpha. Surgeons were blinded to laboratory results prior to laparoscopy.
  
  
  RESULTS
  The pre-operative diagnosis of ovarian torsion was confirmed during an urgent diagnostic laparoscopy in 8 (40%) patients. The surgical diagnosis among the remaining 12 patients was a large ovarian cyst not in torsion. In six out of eight (75.0%) patients with ovarian torsion serum IL-6 concentrations were elevated. None of the 12 patients without torsion had elevated serum IL-6 concentrations. This difference was statistically significant (P < 0.001). There was no significant difference in the proportion of women with elevated serum TNF-alpha concentrations, two of eight (25.0%) patients with torsion and four of 12 (33.3%) control cases.
  
  
  CONCLUSIONS
  Elevated serum IL-6 concentrations, but not serum TNF-alpha concentrations, were significantly associated with the occurrence of ovarian torsion. In patients with vague clinical signs of ovarian torsion, serum IL-6 might help to distinguish which patients should undergo diagnostic laparoscopy.
authors.affiliation: J. Buchman Maternity Center, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, 52621 Israel. s_cohen_eylon@hotmail.com
authors.forename: S B
authors.initials: SB
authors.lastname: Cohen
authors.forename: A
authors.initials: A
authors.lastname: Wattiez
authors.forename: D
authors.initials: D
authors.lastname: Stockheim
authors.forename: D S
authors.initials: DS
authors.lastname: Seidman
authors.forename: A L
authors.initials: AL
authors.lastname: Lidor
authors.forename: S
authors.initials: S
authors.lastname: Mashiach
authors.forename: M
authors.initials: M
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D015415:Biomarkers; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D009994:Osmolar Concentration; D010048:Ovarian Cysts / Q000097:blood; D010049:Ovarian Diseases / Q000097:blood* / Q000175:diagnosis*; D011446:Prospective Studies; D016037:Single-Blind Method; D014102:Torsion Abnormality / Q000097:blood / Q000175:diagnosis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha