Diagnostic value of high sensitive C-reactive protein levels in experimental ovarian torsion in rats

Objective: To evaluate plasma high-sensitivity C-reactive protein (hs-CRP) levels in ovarian torsion models with varied ischemia period and investigate if any consistency between histopathologic findings in ovaries and alternation of plasma hs-CRP levels. Materials and methods: This randomized controlled trial was carried out by Department of Obstetrics and Gynecology in the accordence with Bezmialem Vakif University Animal Research Ethics Committee. Eighteen female adult Sprague–Dawley rats randomly were divided into three groups on the day of the experiment. Group 1 (n=6): Sham group was performed only laparatomy procedure, Group 2 (n=6) was underwent an ovarian torsion model and ischemia of the ovary lasting for two hours, Group 3 (n=6) was subjected to an ovarian torsion model and four hours ischemia was applied to the ovary. Blood samples was drawn before and after the operation to measure plasma hs-CRP levels. Left ovaries of rats in all groups were taken at the end of the procedure. Histopathologic findings of ovaries were scored by pathologist. Ultimate outcomes were evaluated. Results: There was no significant difference in pre-operative plasma hs-CRP levels (p=0,37). The mean plasma hs-CRP levels were not significant in the post-operative course ( two hour ischemia p = 0,2; four hour ischemia p = 1). There is a statistically significant difference among groups in elevation of hs-CRP levels in Group 2 vs Group 1, Group 3 vs Group 2, and Group 3 vs Group 1(p < 0,001, p < 0,001, and p < 0,001, respectively). According to histopathologic findings, compared with Group 1, in Group 2 interstitial edema, follicular cell degeneration, hemorrhage, and inflammatory cell infiltration were of no statistically differance (p = 0,3, p = 1, p = 0,56, p = 1, respectively). Whereas, vascular congestion score was significantly higher in Group 2 than in Group 1 (p = 0,01). Interstitial edema, vascular congestion, follicular cell degeneration, and inflammatory cell infiltration scores had no statistically differance (p = 1, p = 1, p = 0,241, p = 1, respectively) but hemorrhage score was significantly higher in Group 3 than in Group 2 (p = 0,019). Histopathologic scores in Group 3 revealed no statistically differance compared to Group 1 among interstitial edema and inflammatory cell infiltration findings (p = 31, p = 1, respevtively), conversely vascular congestion, follicular cell degeneration, hemorrhage scores were significantly higher in Group 3 (p = 0,001, p = 0,019, p = 0,005, respectively). Conclusions: Elevated hs-CRP levels might not indicates ovarian torsion solely. However, diagnosis of ovarian torsion become easier to establish when plasma levels of hs-CRP increased through the ischemic period.