Importance of complement system components in ovarian endometriomas. A comparative cohort study

Background. Ovarian endometriomas are one of the most common ovarian neoplasms. There are specific ultrasound criteria for this type of endometriosis; however, in some cases, differential diagnosis from other ovarian tumors is challenging.

Aim. To compare the levels of complement system components (C3 and C4) in women with endometriomas and other benign ovarian lesions and to determine the possibilities of using these indicators for differential diagnosis.

Materials and methods. A comparative cohort study of 100 women who underwent surgical treatment of ovarian neoplasms (laparoscopic, cystectomy) was performed. Group 1 included 60 women diagnosed with ovarian endometriomas, and Group 2 included 40 women with other benign ovarian masses (mature teratomas, corpus luteum cysts, ovarian cystadenomas). The C3 and C4 complement components were measured before surgery and 12 months after surgical treatment.

Results. C3 and C4 complement system components before and after surgery were significantly higher in women with ovarian endometriomas (compared with other ovarian masses); p<0.001. Surgical treatment led to a significant decrease in C3 and C4 in both groups; however, the magnitude of this effect was greater in Group 1, i.e., in patients with endometriomas, surgical removal of the mass contributes to a more significant decrease in the complement system components than in other benign masses. It may indicate that surgical treatment of endometrioma affects the overall immunological phenotype.

Conclusion. C3 and C4 levels in women with ovarian endometriomas are higher compared to those in patients with other benign ovarian masses. After surgical treatment of endometrioma, the levels of C3 and C4 decrease but remain higher than in women after surgery due to other ovarian neoplasms.