The accuracy of serum interleukin-6 and tumour necrosis factor as markers for ovarian torsion

BACKGROUND: The aim of this study was to investigate a possible role for in terleukin-6 (IL-6) and tumour necrosis factor (TNF-alpha) as pre-operative markers for the diagnosis of ovarian torsion. METHODS: Twenty consecutive p atients admitted to the gynaecological emergency room with suspected clinic al diagnosis of ovarian torsion were prospectively assigned to the study. B lood samples were drawn pre-operatively and examined for serum concentratio ns of IL-6 and TNF-alpha. Surgeons were blinded to laboratory results prior to laparoscopy. RESULTS: The pre-operative diagnosis of ovarian torsion wa s confirmed during an urgent diagnostic laparoscopy in 8 (40%) patients. Th e surgical diagnosis among the remaining 12 patients was a large ovarian cy st not in torsion. In six out of eight (75.0%) patients with ovarian torsio n serum IL-6 concentrations were elevated. None of the 12 patients without torsion had elevated serum IL-6 concentrations. This difference was statist ically significant (P < 0.001). There was no significant difference in the proportion of women with elevated serum TNF-alpha concentrations, two of ei ght (25.0%) patients with torsion and four of 12 (33.3%) control cases. CON CLUSIONS: Elevated serum IL-6 concentrations, but not serum TNF-alpha conce ntrations, were significantly associated with the occurrence of ovarian tor sion. In patients with vague clinical signs of ovarian torsion, serum IL-6 might help to distinguish which patients should undergo diagnostic laparosc opy.