High-sensitivity C-reactive protein as a novel marker in early diagnosis of ovarian torsion: an experimental study.

Objective: To investigate the effect of ovarian torsion on plasma high-sensitivity C reactive protein (hs-CRP) levels and to determine whether hs-CRP levels were a useful adjunct that could be used in the diagnosis of ovarian torsion.

Materials And Methods: Sixteen nulligravid 4-month-old female Wistar albino rats were randomly and equally allocated into two groups. Control group, sham operation (n = 8) group, and study group, ovarian torsion (n = 8) group. Ovarian torsion model was created using titanium vascular clips and vascular clips were kept for a 2-h period. Right ovaries were surgically removed at the end of the procedure in each group. Blood was sampled before and after operation to assess plasma hs-CRP levels. Ovarian histopathologic findings scores and plasma hs-CRP levels were evaluated.

Results: In study group, the mean plasma hs-CRP level was significantly higher than that in the control group. (0.91 ± 0.18 vs. 0.39 ± 0.06 mg/l, respectively, p < 0.001), following 2 h of ovarian torsion. Histologic examinations of the right ovary confirmed the torsion model. Histologic score of the specimens had higher scores for follicular cell degeneration (p = 0.002), vascular congestion (p = 0.002), inflammatory cell infiltration (p = 0.003), and hemorrhage (p < 0.001) in the study group. For the change in the plasma hs-CRP value for a cut-off value of >0.275 mg/l, sensitivity and specificity were calculated as 100 %.

Conclusion: The measurement of hs-CRP in a rat model seems to be a valuable plasma marker in early detection and diagnosis of ovarian torsion. However, further clinical and experimental studies of a larger size are required.