Mean Platelet Volume in Early Diagnosis of Adnexal Torsion

Abstract

Background: Adnexal torsion (AT) is among the gynecological emergencies; more common in reproductive age, if diagnosed late, this can cause ovarian failure and infertility, but rarely thrombophlebitis and peritonitis. Despite these severe complications, preoperative diagnostic tests are not enough for early diagnosis. There are certain pieces of literature on the subject that reveal changes in mean platelet volume (MPV) values occur in inflammatory and ischemic diseases and that these changes have diagnostic and prognostic significance. However, there are no studies investigating this relationship with adnexal torsion. Aims: The aim of the study is to investigate the diagnostic and prognostic significance of the mean platelet volume value in the early diagnosis of patients with adnexal torsion. Study Design: Case-control study. Methods: Pre-operative demographic data, MPV, leukocyte count and neutrophils to lymphocytes (N/L) ratio in the blood samples of 51 patients, who were operated on preliminary adnexal torsion and diagnosed as adnexal torsion with a benign ovarian cyst (AT group) were retrospectively compared with those of 50 patients who were operated upon because of benign ovarian cysts and without torsion (control group) at this hospital between 2006 and 2014. Results: The mean MPV level was found to be 8.1 (7.1-10.7) fL in the AT group and 7.9 (6.6-10.2) fL in the control group; no statistically significant difference was found between the groups (p>0.05).Leukocyte count and N/L ratio in the AT group were, on average, 12x103/mm3 and 82% respectively and in control group; they were, on average, 7.2x103/mm3 and 59%, respectively. A statistically significant increase was found in the leukocyte count and N/L ratio of the AT group compared to the control group (p<0.001). The platelet count in the AT group was, on average, 253x103/mm3 and in the control group it was, on average, 280x103/mm3; no statistically significant difference was detected between these two groups (p>0.05). No correlation was detected between the MPV, platelet and leukocyte counts. The sensitivity of the leukocytosis to the AT cases was found to be 66.7%, and selectivity was 94%. Conclusion: The AT diagnostic and prognostic importance of MPV value has not been determined in this study.

Keywords

• Adnexal torsion, mean platelet volume, neutrophils to lymphocytes ratio, platelet, leukocyte, leukocytosis

References

1. 1. Hassan J, Tsafrir Z, Azein F, Bar-On S, Almong B, Mashiach R, et al. Comparison of adnexal torsion between pregnant and nonpregnant women. Am J Obstet Gynecol 2010;202:536. [CrossRef]
2. 2. Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol 2010;150:8-12. [CrossRef]
3. 3. Rackow BW, Patrizio P. Successful pregnancy complicated by early and late adnexal torsion after in vitro fertilization. Fertil Steril 2007;87:697. [CrossRef]
4. 4. Bar-On S, Mashiach R, Stockheim D, Soriano D, Goldenberg M, Schiff E, et al. Emergency laparoscopy for suspected ovarian torsion: are we too hasty to operate? Fertil Steril 2010;93:2012-5. [CrossRef]
5. 5. Beyazit Y, Sayilir A, Torun S, Suvak B, Yesil Y, Purnak T, et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012;36:162-8. [CrossRef]
6. 6. Seker A, Incebiyik A, Kucuk A, Terzi A, Yucel Y, Ciftci R, et al. Platelet volume in patients with acute and chronic cholecystitis. Acta Medica Mediterranea 2013;29:515.
7. 7. Narci H, Turk E, Karagulle E, Togan T, Karabulut K. The role of mean platelet volume in the diagnosis of acute appendicitis: a retrospective case-controlled study. Iran Red Crescent Med J 2013;15:e11934. [CrossRef]
8. 8. Incebiyik A, Seker A, Vural M, Gul Hilali N, Camuzcuoglu A, Camuzcuoglu H. May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease? Wien Klin Wochenschr 2014;126:422-6. [CrossRef]

9. 9. Artunc Ulkumen B, Pala HG, Calik E, Oruc Koltan S. Can Mean Platelet Volume and Platelet Distrubition Width be Possible Markers for Ectopic Pregnancy and Tubal Rupture? (MPV and PDW in Ectopic Pregnancy). Pak J Med Sci 2014;30:352-5.
10. 10. Houry D, Abbott JT. Ovarian torsion: a fifteen-year review. Ann Emerg Med 2001;38:156-9. [CrossRef]
11. 11. Erdemoğlu M, Kuyumcuoglu U, Guzel AI. Clinical experience of adnexal torsion: evaluation of 143 cases. J Exp Ther Oncol 2011;9:171-4.
12. 12. Balci O, Icen MS, Mahmoud AS, Capar M, Colakoglu MC. Management and outcomes of adnexal torsion: a 5-year experience. Arch Gynecol Obstet 2011;284:643-6. [CrossRef]
13. 13. Tobiume T, Shiota M, Umemoto M, Kotani Y, Hoshiai H. Predictive factors for ovarian necrosis in torsion of ovarian tumor. Tohoku J Exp Med 2011;225:211-4. [CrossRef]
14. 14. Sommerville M, Grimes DA, Koonings PP, Campbell K. Ovarian neoplasms and the risk of adnexal torsion. Am J Obstet Gynecol 1991;164:577-8. [CrossRef]
15. 15. Mazouni C, Bretelle F, Ménard JP, Blanc B, Gamerre M. Diagnosis of adnexal torsion and predictive factors of adnexal necrosis. Gynecol Obstet Fertil 2005;33:102-6. [CrossRef]
16. 16. Descargues G, Tinlot-Mauger F, Gravier A, Lemoine JP, Marpeau L. Adnexal torsion: a report on forty-five cases. Eur J Obstet Gynecol Reprod Biol 2001;98:91-6. [CrossRef]
17. 17. Chiou SY, Lev-Toaff AS, Masuda E, Feld RI, Bergin D. Adnexal torsion: new clinical and imaging observations by sonography, computed tomography, and magnetic resonance imaging. J Ultrasound Med 2007;26:1289-301.
18. 18. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002;13:301-6. [CrossRef]
19. 19. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-α therapy. Rheumatol Int 2010;30:1125-9. [CrossRef]
20. 20. Albayrak Y, Albayrak A, Albayrak F, Yildirim R, Aylu B, Uyanik A, et al. Mean platelet volume: a new predictor in confirming acute appendicitis diagnosis. Clin Appl Thromb Hemost 2011;17:362-6. [CrossRef]
21. 21. Bilici S, Sekmenli T, Göksu M, Melek M, Avci V. Mean platelet volume in diagnosis of acute appendicitis in children. Afr Health Sci 2011;11:427-32.
22. 22. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med 2012;44:805-16. [CrossRef]
23. 23. Kartal O, Kartal AT. MPV: a reliable method to determine the prognosis? Ren Fail 2014;23:1.