Nuh Mehmet ERBAKIRCI, Ayşe Ender YUMRU
Anatolian Journal of Obstetrics and Gynecology Research - 2025;2(3):117-123
Purpose: Metastin has been shown to inhibit metastasis in breast cancer and malignant melanoma and is reported to be elevated in patients with polycystic ovary syndrome (PCOS). We hypothesized that in PCOS patients presenting with an adnexal mass, metastin levels would demonstrate a negative correlation with tumor markers in cases of malignancy . The aim was to evaluate plasma metastin levels and their relationship with tumor markers in PCOS patients in whom adnexal masses were detected. Methods: This prospective observational case-control study was conducted after obtaining approval from the University of Health Sciences Turkey , Şişli Hamidiye Etfal Training and Research Hospital Ethics Committee (approval no: 742, date: 24.01.2017). Between February and July 2017, women aged 18-49 years who had previously been diagnosed with PCOS and who presented to the gynecology and obstetrics clinic were evaluated. Patients with adnexal masses detected during examination and PCOS patients without adnexal masses were included, while patients who did not meet inclusion criteria or did not wish to participate were excluded. Patients with masses and without masses were included. The number of patients in the groups was determined by power analysis based on previous studies, with 90% power and a 0.05 alpha error. Serum metastin, cancer antigen (CA) 125 (<35 U/mL), CA 19-9 (<37 U/mL), and carcinoembryonic antigen (CEA) (<5.0 ng/mL) levels were measured. For comparisons between the two groups, Student's t-test was used for normally distributed variables, and the Mann-Whitney U test for non-normally distributed variables. Spearman correlation was used for non-normally distributed variables in correlation analyses. Chi-square test was used for categorical variables. A p value of <0.05 was considered statistically significant, and statistical analyses were performed using SPSS version 25. Results: A total of 83 patients were included, 40 (48.2%) in the control group and 43 (51.8%) in the case (adnexal mass present) group. The case group had significantly higher mean age and CA-125 values ( p<0.05). No significant difference was found between groups in levels of metastin, CA-19.9 and CEA, or age at menarche. No significant correlation was found between metastin and tumor markers in the case group. Conclusion: Although a significantly higher CA-125 value in the case group compared to the control group was expected, the lack of difference in metastin levels between the groups, despite all patients being diagnosed with PCOS, suggested that even if pelvic masses are detected in long-term PCOS patients with high metastin levels, the likelihood of malignancy may be low.
